Syringomyelia; an update on clinicopathological studies, diagnosis, and management

This study aims to cite the recent research findings related to Syringomyelia's origin, progression, and pathophysiology, followed by its diagnosis and relevant therapeutic approaches. Syringomyelia is a neurological condition used as a generic terminology until any etiology is determined and is characterized by the development of fluid-filled syrinx within the central canal of the spinal cord. Hindbrain herniation, Chiari malformations, spinal arachnoiditis, and spinal tumors are the most common etiologies associated with Syringomyelia. The prevailing theories regarding the pathophysiology of Syringomyelia suggest that high pulse pressure in subarachnoid spaces pushes the cerebrospinal fluid into the syrinx through the spinal cord. Although the incidental prevalence of idiopathic Syringomyelia is more common, the symptomatic clinical presentation includes sensory and motor dysfunction development. However, the manifestation of clinical symptoms is highly variable depending on associated etiology. With the advancement in diagnostic radiology, identification and image sizing of syrinx have become relatively approachable. Magnetic resonance imaging, computerized tomography, and diffusion tensor tractography have been widely used to locate the cyst site, leading to accurate diagnosis of Syringomyelia. The purpose of treatment is to spot and correct the primary causative pathophysiology. Syringomyelia management relies on restoring the normal cerebrospinal fluid flow and improving the regular flow dynamics. The choice for nonoperative and operative treatment depends on syrinx location, size, etiology and symptomatic presentation. Surgical intervention is the only choice of treatment for symptomatic patients with abnormal imaging outcomes. Future investigations should be centered on better management of diagnostic strategies, surgical intercession and postoperative supervision, along with a lucid understanding of the pathogenesis of Syringomyelia.