Do I need surgery?

[asanders1016]

I have recently been diagnosed with syringomyelia. I was wondering is moderate narrowing of the Right foramen serious?   Here is my MRI report and I need to know if this means I do or do not need surgery:
Multiple pulse sequence in sagittal and axial planes reveal normal vertebral alignment.  There is a posterior bulge of the C4-C5 disc without direct evidence of acute herniation.  There is mild narrowing of the neural foramen on the left.  There is moderate narrowing of the neural foramen on the right.  At C5-C6 there is a broad-based posterior bulge of the disc without direct evidence of acute herniation.  There is mild narrowing of the neural foramina bilaterally.  At the other levels the discs are intact and the neural foramina are patient.  The spinal cord is normal in caliber.  There is signal alteration compatible with syringomyelia from aproximatley the level of C4 through the level of T2.  The spinal cord is normal in size.  The base of the brain is normal in contour and position.

[selmaS]

  A Syrinx is Syringomyelia a cyst that fills with CSF and most times is the result of an obstruction to CSF....these can lead to perm nerve damage so this is one reason to have surgery to help shrink the syrinx.

Chiari is the malformation of the cerebral skull which houses the cerebral tonsils, bcuz the area is smaller and forces the tonsils to herniate...depending on the width of the tonsil it may cause an obstruction to CSF flow....

Both conditions can cause symptoms together or alone...so some issues can be from the syrinx and not Chiari....and vice versa.

[asanders1016]

I'm stumped too because of the research I've done doesn't quite match up to some of what they have told me.  Yes my MRI was only of the upper spine and my head.  On the second page of my MRI report it does say on #3 Cervical cord syrinx.  Is a syrinx and a Chari the same or different?

[selmaS]

  So if I am understanding u, u were DX'd with congenital syringomyelia, but no mention of Chiari?

And which MRI's were done, just the brain and cervical spine?

I have heard of some with syringomyelia being born with it, but many do have a form of low lying tonsils or Chiari as well....hmmmm I am stumped.

[asanders1016]

My Dr. said I was probibly born with it but she couldn't tell me much more than that.  from the research ive done it looked that if I was born with it that the base of my brain would be pushing down onto the spine causing it to form the syrinx.  My report says however that the base of the brain is normal in contour and position. I have never had a spine injury so I don't know how it happened.

[selmaS]

  Oh u r in the military...thank you for your service <3

There are a few VA Drs that know about Chiari and syringomyelia and we have a few other members in service that can share those names with u.

DO u feel this is more an injury issue or do u feel it is congenital?

[asanders1016]

Thank yu for your thoughts.  I have been going through the VA but since theiitial call last month to tell me tht I have syringmyelia I have not talked to a single Dr.  I'm frustrated and scaedof having permanent damage.  I did request copies of my MRI & X - Ray so I should be recieving them shortly.  I missd the rest of my report I id get from them.  1) Chronic findings to include the multiple bulging discs and narrowed foramina.  2) No direct evidence of acute disc herniation.  3) Cervical cord syrinx.

[selmaS]

  Hi and welcome to the Chiari & Syringomyelia forum.

First, get copies of ur MRI if u do not already have them....many times the Chiari if present is considered an insignificant finding and is reported as "normal"

SO, u may have Chiari even tho this does not suggest it....then, u need to see what other related issues.

If u have Chiari is that what caused ur syrinx to form, did u have an injury, from a fall or MVA that caused ur syrinx....this will help u to know how to treat it,

Most times with a syrinx they do decompression surgery for Chiari to help the syrinx shrink...for just a syrinx they do not always do surgery as most times the syrinx is too small for a stent or shunt....

I am not sure if the disk issues u have could have caused the syrinx....so not sure what is in store...for now it looks like more testing and get them reviewed by a true Chiari specialist as they treat Syringomyelia too.