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does no syrinx = no surgery?
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does no syrinx = no surgery?

Hi all,

Still waiting for the call from my NS...trying not to obsessively look at my MRI scans in the meantime. I don't see a syrinx and my symptoms, while very discomforting, are not currently debilitating.  I might take one or two days off work a month with headaches and usually rely on Excedrine migraine just about every day. I have a lot of symptoms of Chiari but I don't know if he will now say that without a syrinx surgery is unecessary. I am not opposed to that, I just want to know!  Sorry this is a bit of a vent...does no syrinx take surgery off the table?  
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1903798_tn?1333908888
I am only going on what I have read but it looks like they look at symptoms, csf flow, syrinx and I am not sure what else.  I have read of some that had surgery before got syrinx so it looks like it could still be necessary for some to me.  I have also read of some they monitored and waited if quality of life was ok.
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1910752_tn?1329493822
I just had a stroke of genius, called medical records and they sent me a release so that they could fax me the MRI report.  
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620923_tn?1405964489

  Hi...No syrinx does not = no surgery...what u need to know is do u have a CSF obstruction...if u do a syrinx can develop if u do not have one already...if u do not surgery is to restore flow and prevent the onset of one in developing...Once u have one u have higher risks of perm nerve damage...so they do not want to wait till mu have a syrinx...flow is the biggy, next to ur symptoms and quality of life.

Netime u go for a MRI, u can request the report to be sent to u as soon as it is available.....u sign for it as  u sign in...and get the CD b4 u leave, that way u have the report in hand b4 u go to ur Dr and can formulate questions.

  "selma"
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Avatar_f_tn
What selma said, lol. I had surgery and did not have any really debilatating symptoms, nor did I have a syrinx, but I did have obstructed CSF flow and my symptoms were worsening, so we (me and my NS) decided to go ahead and have surgery. I am 7 weeks out and I feel a lot better because of the surgery.
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1910752_tn?1329493822
Ok, got the report.  Here we go:

For the cervical spine - The cerebellar tonsils are ectopic.  These extend up to the bottom of the posterior arch of C1.  Marrow signal is within normal limits.  No disc bulge.  No central canal stenosis.  No foraminal stenosis.  The cord signal is within the normal limits.

Impression:  No cord signal abnormality or syrinx.  Chiari 1 Malformation.

For the thoracic: The cord signal is within normal limits. Signal in the marrow is normal.  Small right paracentral disc protrusion at T-3-T-4 extending posteriorly of about 2 or 3 mm.  No central canal stenosis or foraminal stenosis.  Disc heights are normally maintained.

Impression: No cord signal abnormality of vertrebal body anamoly in the thoracic spine.

For the lumbar: Marrow signal is within normal limits.  Conus terminates at top if T2.  Discs are within normal limits. No disc bulge or central canal stenosis or foraminal stenosis.

Impression: Unremarkable MRI of lumbar spine.
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620923_tn?1405964489


  Sounds like chiari with out a syrinx or sicks issues which is good....now u need a CINE MRI....and wait to see how the NS reads the films...this is just the opinion of the radiologist.....

Since there is no signal abnormality the Dr may not want or feel the need for the  CINE.....all depends on the Dr....
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1910752_tn?1329493822
What does the cord signal refer to? Is that the CSF flow?
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620923_tn?1405964489

  I am taking it to mean just that...the flow, bcuz the signals from the brain to the nerves flow in the fluid to the correct nerve endings...if there is an obstruction that is when we have drop attacks as the signals do not get thru to keep us standing.....

  Again, u have to wait and see if there is nething else the NS may see that the radiologist did not.

   "selma"
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1306714_tn?1327260680
I wanted to tell you I went to 3 NS all together before finding one I was comfortable with, but I went to one Chairi specialist in a very well known university and they told me I wasn't a canadaite for surgery.  When finally finding the right Dr. for me he stated making the decision of having surgery is "If it is altering your life".  I couldn't make it through the day without crying because I had to relief the pressure in my head.  Some dr.'s want to have you have surgery right away.  I think having Chairi is so flustrating for most of us because of the fact that you get so many different answer's and having surgery is a serious decision.  Just wanted to wish you the best.  Let us know how your appt goes.
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Avatar_m_tn
I have a small syrinx in my thoaric cord and the pain gets worse and worse everyday I was just wanting to see what everybody else thought the doctors would do or if there anything that I can take for the pain that has helped anyone else
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620923_tn?1405964489

  Hi and welcome to the Chiari forum.

Do u also have Chiari? Many times a syrinx is too small for surgery or a shunt on the syrinx itself, but when teamed with chiari the decompression surgery is done to restore CSF flow and with hopes the syrinx will shrink.

  A Chiari specialist is one of the NS's well experienced with the treatment of a syrinx.

Did ur Drs tell u how ur syrinx formed, is it congenital, result of a CSF obstruction or an injury?
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