SCIThis is the complication every person with SCI should be able to recognize, because it can show up months or years after injury and quietly take away function you'd kept. The headline: any new loss of sensation, strength, or function — especially moving upward from your injury level — needs to be checked.
What It Is
After SCI, scar tissue and adhesions can block the normal flow of cerebrospinal fluid around the cord. Fluid then collects inside the cord and forms a cavity called a syrinx. Over time the syrinx can enlarge and damage more of the cord — often above your original injury level, which is why it can cause you to lose abilities you had stabilized.
The Warning Signs
A simple self-check many people use: periodically test where pin-prick and temperature sensation begin. If that level creeps higher than it used to be, that's an early red flag.
Why Catching It Matters
An untreated, expanding syrinx tends to be progressive — the damage it causes is often permanent. Surgery can stop the progression, but it can't always reverse what's already lost. So the entire game is catching it early, while there's still function to protect. That's why new symptoms are never something to "wait and see" with.
Diagnosis
Diagnosis is by MRI, which clearly shows the syrinx and any cord tethering. If you can't have an MRI (certain implants), a CT myelogram is the alternative. Because symptoms can be subtle, push for imaging if you and your doctor notice a real change.
Treatment
Treatment is surgical and aims to restore fluid flow and decompress the cord:
- Untethering with duraplasty — freeing the cord from scar tissue (arachnoidolysis) and enlarging the space around it with a graft so fluid flows freely.
- Shunting — a small tube to drain the syrinx.
- Cordectomy — in select cases with no function below the level, cutting across the cord to open the cavity.
The goal is to halt progression and protect remaining function. Outcomes are best when the syrinx is treated before major loss occurs.
What Nobody Tells You
- It can appear years later. Long after you've stabilized and stopped thinking about new complications, a syrinx can develop. Stay alert to change indefinitely.
- "Ascending" is the key word. Most SCI symptoms relate to your known level. New problems moving upward — a higher sensory line, new hand or arm changes in a paraplegic — are the classic syrinx warning.
- Track your baseline. Knowing your normal sensation level and function makes a new change obvious. Some people note it once a year.
- Early surgery protects, it rarely restores. The reason to act fast is to keep what you have — don't let new symptoms ride.
Sources & Further Reading
This page combines lived SCI experience with published clinical guidance, including:
- Syringomyelia — National Institute of Neurological Disorders and Stroke (NINDS)
- the MSKTC factsheet library — Model Systems Knowledge Translation Center (MSKTC) (see the factsheet library)
- Spinal Cord Injuries — MedlinePlus (U.S. National Library of Medicine)
SCI.help articles are information, not medical advice. Practice varies by injury level, provider, and institution — always confirm specifics with your own care team.