This Is MS Multiple Sclerosis Knowledge & Support Community

It pays to be open and stay open is even more important in my opinion.
We think we find the 'it' and latter learn it was only an indicator ................ Life, but not as we know it ;)

When should I inspect for a signed copy of the book in the mail?

;)
Nigel

Readable info about the spine for people like me

http://www.laesieworks.com/spinal/SCIinfo01.html

Nigel,
It will take another month or two to finish my final edits before it goes to the boss for fact checking and editing. After that it goes to the publisher, which will probably be in the spring.

Robert,
The section on Neuromyelitis Optica is under disorders of the spinal cord, which includes spinal cord injuries. The NMO section follows Transverse Myelitis, which is one of the signs of NMO. Transverse myelitis is followed by Beck's disease, also know as Anterior Spinal Artery Syndrome, which is followed by Amyotrophic Lateral Sclerosis and Primary Lateral Sclerosis.

Hello Uprightdoc,

I'm "the woman" where Robnl is talking about
I have to say that my Englisch is not very well with writing unfortunately, so I hope you understand it

In brief I have syringomyelia from C6 till Th10 and my spinal cord is crushing at level Th4/Th5 but they don't know if its because a hernia or a hard bone.

I have many questions but I have to wait till the 2nd of february till I get some answers I hope, or can I ask some questions to you?

Kind Regards

Francis

Hello Francis,

Your English is very easy to understand.

The large syrinx is the lower spinal cord is unusual. It sounds as though you have a herniated disc or a bone spur (osteophyte) at the T4/5 level that is compressing the thecal sac. The thecal sac is the protective covering that surrounds the cord called meninges. If the protruding disc of bone spur is pressing on the thecal sac then it is also compressing the epidural vertebral veins that surround the cord. Compression of the veins surrounding the cord alters craniospinal hydrodynamics (hydraulics) which can lead to the formation and maintenance of syrinxes in the cord.

Ask as many questions as you wish.

Warm regards,
Dr. F

Dear Dr. Flanagan,

Thank you for the fast reply!
I appreciate it very much!

I have tried to translate the text to Dutch so I get it, but I find it a little bit difficult
If I get it right, you say that the herniated disc or bone spur may have cost the syrinxes in the cord?

The neurosurgeon wants to operate me at T4/5 level but also tell me that my spinal cord is very thin.

If you want and I know how I can send you a picture from the mRI image?

I have very strange eye problems, my sight is going backwards in a very fast way? On the mRI image of my brain is nothing to see what can explain my eye problems.

Is it possible that the syrinx can cause my eye problems?

Kind regards,

Francis

Hello Francis,

You're very welcome.

The herniated disc or bone spur probably did not cause the syrinx. Because the it is so far down in the cord, I suspect that the herniated disc or bone spur are most likely contributory to the maintenance of the syrinx in your case.

Syrinxes are formed in the central canal of the spinal cord. The central canal of the spinal cord is structurally related and often connected to the fourth ventricle of the brain. There are three basic theories regarding the formation of syrinxes in the central canal. The three theories are related to pressure gradients. One theory maintains that syrinxes are formed by increased pressure from "water hammers" caused by obstruction to the flow of cerebrospinal fluid (CSF) out of the fourth ventricle. The second theory is based on piston pressure caused by Chiari malformations. Chiari malformations occur when the brainstem sinks in the cranial vault and descends into the foramen magnum. The descent of the brainstem into the foramen magnum creates a "piston" effect that forces fluids into the cord and central canal. The third theory is that blockage of CSF flow between the cranial vault and spinal canal causes a "dissociation" of CSF flow. The dissociation of CSF flow decreases pressure in the epidural space and vertebral veins surrounding the cord and central canal. The decrease in pressure surrounding the central canal allows the syrinx to expand because it is not opposed by surrounding pressure.

The problems with vision are not directly related to the syrinx. I suspect that you may have design problems in the cranial vault that affect blood supply to the optic nerve and eye. The fact that you have a herniated disc or bone spurs at T4/5 (spondylosis) makes me suspect that you may have had a traumatic injury. If you do not have a history of trauma you may have a design problem in the spine.

I would be happy to take a look at your MRI images. Although his server is somewhat slow for sending messages in a bottle across the Atlantic, Robert can explain how to send the images to me.

Dr F I think the analogy that you used in your book about a balloon that is inflated about half full then squeezed to form a protruding bulge gives a good insight into hammering and constrictions of flow. Then considering that the total balloon is within a tunnel aka the spinal structure is around it, which gives little option or places for the bulge/s of pressure to travel to and expand. Those places that it can or do expand the shape of the balloon/a syrinx compresses the spinal cord which is the nerve transmission medium. The pumping actions from all sorts of things such as fluid compression from flow, or fluid compression from external compression of the sac, or fluid compression from bending which changes the available expansion space in the spinal structure helps me picture the action that could occur.
It wasn't until I imagined the balloon is within a tunnel that I realized that the bulges and bending of the back/spine will impose huge forces on the fluid within the thecal sac. One thing for a balloon to be full of air and rapidly fluid in movement, a whole different proposition when fluid rather than air trapped and restricted by the 'tunnel' that the spinal cord is within.

Nigel, You hit the nail on the head. It's all about hydraulics.

Thank you for your reply and explanation.

In the past I had some accidents..

1999 scooter accident
2002 car accident
2012 I fall of the stairs

I send Robert a pm, would you also like to see a mRI image from the brain?

Also I have a swelling ( lymph node ) in the left side of my neck ( since I fall of the stairs ) and my general practitioner says maby I can get the flu or something else and that de lymph node is working good. But I "still wait for the flu" ;)
Do you have any idea if it maby had something to do with the syrinx?

Unfortunately my complaints list is very long, I don't want to bodder you with everything

Kind regards,

Francis

It would be helpful to see your brain scan to check the design of the cranial vault and the upper cervical angles if possible.

The swelling in your neck has nothing to do with the syrinx. There are different causes of swelling in the neck. Is the doctor certain that the swelling is a lymph node? Where is the swelling? Is the swelling at the base of your skull? Is the swelling in the lower neck? You may have a swollen muscle. A swollen muscle makes more sense considering that you fell down stairs in 2012. The fall down stairs, could have caused a herniated disc at T4/5 but it is too soon to form a bone spur. The car or scooter accident are more likely to have caused the injury at T4/5. Disc injuries in the thoracic spine are less common because the bones of the spine are braced by the ribs. Hyperflexion injuries such as landing on the back of your neck and upper back while in a tight ball position can cause a hernia in the thoracic spine. For example, similar injuries can occur from diving and wrestling activities.

Hopefully Robert sped up his sluggish servers since last time. Have him put your images in a bottle and throw them over the dike. I look forward to seeing them. I can only imagine what the doctors are overlooking.

HMmm, okay

I'm trying to send the pictures to you Dr. Flanagan.

The image is too small to see detail but it looks as though the syrinx is from C6 or 7 down to T3 not T10. The little detail I can see of the cervical spine (neck) is relatively normal. I can't see the details of the herniated disc or bone spur at T4/5 in this image. It would be helpful to see the brain scan.

Oke I got to try to find some better mRI images or maby some different images and try to post them here or trough pm.

The neurosurgion tell me that I have a syrinx from C6 till Th10 and that the syrinx from C6 till Th4 is expanding if I say it right?

Kind regards,

Francis