Chiari malformation, cervical disc prolapse and syringomyelia - always think twice

Department of Neurosurgery, Royal North Shore Hospital, Pacific Highway, St. Leonards, 2065 New South Wales, Australia.
Journal of Clinical Neuroscience (Impact Factor: 1.38). 05/2008; 15(4):474-6. DOI: 10.1016/j.jocn.2006.10.026
Source: PubMed


We present the case of a 36-year-old man with neck pain and parasthesia of both upper limbs. Magnetic resonance imaging demonstrated a cervical disc protrusion with spinal cord compression, a Chiari I malformation and cervical syringomyelia. On clinical grounds it was suspected that the cervical stenosis was the symptomatic pathology and an anterior cervical decompression was performed, followed by arthroplasty. Post-operative imaging demonstrated adequate canal decompression, preserved cervical mobility and near-complete resolution of the syrinx. Syringomyelia has a multitude of causes and synchronous pathology can occur. Cervical spondylosis is infrequently associated with syringomyelia. Chiari I malformations are increasingly incidentally detected and asymptomatic. This first report of arthroplasty for cervical spondylosis associated with syringomyelia adds to the growing body of experience with this new technology.

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