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Condition/Disorder Synonyms

  • Syringomyelia

  • Syrinx

  • Spinal cord cavitation

ICD-9-CM Code

  • 336.0 Syringomyelia and syringobulbia

ICD-10-CM Code

  • G95.0 Syringomyelia and syringobulbia

Preferred Practice Pattern1

Key Features

Description

  • Damage to the spinal cord due to the formation of a fluid filled cavity within the spinal cord

Essentials of Diagnosis

  • 4 types of syringomyelia

    • Types I, II, IV are developmental

    • Type III is acquired and associated with one of the following

      • Spinal cord tumor

      • Traumatic myelopathy

      • Spinal arachnoiditis and pachymeningitis

      • Secondary myelomalacia from cord compression, infarction or hematomyelia

General Considerations

  • Type III syrinx is suspected when a person with a previously stable presentation experiences changes in sensorimotor function after a spinal cord injury that extends above the level of the original injury.

Demographics

  • Occurs more often in people with tetra/quadriplegia than in those with paraplegia

Clinical Findings

Signs and Symptoms

  • Pain

  • Spreading sensory loss

  • Spreading motor loss

  • Spasticity or involuntary muscle contraction

Functional Implications

  • Progressive loss of function until the problem is treated

  • Loss of functional mobility and independence with ADLs

Possible Contributing Causes

  • Previous spinal cord trauma is a risk factor

  • Congenital spinal malformations

Differential Diagnosis

  • Stenosis

  • Spondylitis

  • Arachnoiditis

  • Meningitis

  • Tangier disease

  • Fabry disease

  • Amyloid polyneuropathy

Means of Confirmation or Diagnosis

Laboratory Tests

  • Spinal tap via lumbar puncture

Imaging

  • MRI

  • CT scan for detailed imaging

Referrals/Admittance

  • Neurologist

  • Neurosurgeon to repair syrinx, restore normal cerebral spinal fluid flow, and relieve pressure on spinal cord

  • Neuro-oncologist

  • Occupational therapist

  • Counselor, psychologist, neuropsychologist

Impairments

  • Peripheral nerve integrity

  • Gait

  • Wheelchair mobility

  • Balance

    • Static sit

    • Dynamic sit

    • Static stand

    • Dynamic stand

    • Moving outside the base of support (BOS)

  • Muscle strength

  • Muscle recruitment

  • Coordination

  • Postural control

  • Posture

  • ROM

  • Reflexes

    • Deep tendon reflex (DTR)

    • Babinski

    • Clonus

  • Muscle tone

  • Sensation

  • Bed mobility

  • Transfers

  • Endurance

  • Aerobic capacity

  • Self-care

  • Home management

  • Fine motor

  • Respiratory compromise

Tests and Measures

  • American Spinal Injury Association (ASIA) assessment

    • Motor

    • Sensation

    • ASIA classification neurologic level

    • Complete vs. incomplete

    • Functional mobility

      • Functional independence measure (FIMTM)

    • Wheelchair mobility

    • Transfers

    • Gait (timed up and go, 10-meter walk test, functional gait assessment, walking index for spinal cord injury)

  • Sitting and standing (for people with incomplete injuries or damage in the lower ...

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