Chiari malformation, cervical disc prolapse and syringomyelia--always think twice.
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.
Ball
Jonathon R
JR
Department of Neurosurgery, Royal North Shore Hospital, Pacific Highway, St. Leonards, 2065 New South Wales, Australia. dr.ball@optusnet.com.au
Little
Nicholas S
NS
D000328:Adult; D001139:Arnold-Chiari Malformation / Q000150:complications*; D002574:Cervical Vertebrae / Q000473:pathology* / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000473:pathology / Q000601:surgery; D007796:Laminectomy / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D013117:Spinal Cord Compression / Q000150:complications* / Q000601:surgery; D013595:Syringomyelia / Q000150:complications* / Q000601:surgery