JNNP: Spontaneous resolution of cervical thoracic syringomyelia after significant weight loss

Syringomyelia or cavitation is a fluid-filled cavity in the spinal cord that can produce symptoms of progressive myelopathy

This article reports a case in which a woman's neck-thoracic cavity spontaneously disappeared after a significant weight loss

A 42-year-old morbidly obese woman with a body mass index (BMI) of 52 kg/m ² presented with persistent radiating pain in her hands for several months

² MRI examination of the cervical spine, thoracic spine and lumbar spine without injection of contrast medium revealed a huge cervical and thoracic spine cavity with a maximum diameter of 14 mm

MRI at the first consultation before weight loss 

Taking into account the patient's morbid obesity and relatively mild neurological symptoms, the patient agreed to undergo a weight loss test to reduce the risk of surgery

At her next follow-up, she lost about 40 pounds and her body mass index increased to 38 kg/m ²

One year later, the patient's neurological symptoms were relieved, and the MRI of the spinal cord showed that the cavity had almost completely subsided

Syringomyelia is most common in Chiari malformation, but can be secondary to trauma, intramedullary spinal cord tumors, or tethered cord

Interestingly, after decompression of the posterior fossa, syringomyelia was indeed relieved in these cases, as expected by Chiari I malformation

MRI image after significant weight loss

Others describe the rare spontaneous resolution of syringomyelia (only 8 cases have been reported in the literature), especially the case associated with Chiari I malformation, which is the first reported case of syringomyelia disappeared after weight loss

Nevertheless, for non-mechanical syringomyelia, weight loss may be a conservative treatment option
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BrayDP ,BouobdaG ,LaxpatiNG BrayDP Bray BouobdaG Bouobda LaxpatiNG Laxpati , et al Spontaneous resolution of cervicothoracic spinal cord syrinx after significant weight loss Journal of Neurology, Neurosurgery & PsychiatryPublished Online First:14 July 2021.
Published Online First: doi:10.
1136/jnnp-2020-325720 doi:

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