, Volume 58, Issue 8, pp 771–775 | Cite as

Cervical spinal canal narrowing in idiopathic syringomyelia

  • Aaron F. Struck
  • Carrie M. Carr
  • Vinil Shah
  • John R. Hesselink
  • Victor M. Haughton
Diagnostic Neuroradiology



The cervical spine in Chiari I patient with syringomyelia has significantly different anteroposterior diameters than it does in Chiari I patients without syringomyelia. We tested the hypothesis that patients with idiopathic syringomyelia (IS) also have abnormal cervical spinal canal diameters. The finding in both groups may relate to the pathogenesis of syringomyelia.


Local institutional review boards approved this retrospective study. Patients with IS were compared to age-matched controls with normal sagittal spine MR. All subjects had T1-weighted spin-echo (500/20) and T2-weighted fast spin-echo (2000/90) sagittal cervical spine images at 1.5 T. Readers blinded to demographic data and study hypothesis measured anteroposterior diameters at each cervical level. The spinal canal diameters were compared with a Mann-Whitney U test. The overall difference was assessed with a Friedman test. Seventeen subjects were read by two reviewers to assess inter-rater reliability.


Fifty IS patients with 50 age-matched controls were studied. IS subjects had one or more syrinxes varying from 1 to 19 spinal segments. Spinal canal diameters narrowed from C1 to C3 and then enlarged from C5 to C7 in both groups. Diameters from C2 to C4 were narrower in the IS group (p < 0.005) than in controls. The ratio of the C3 to the C7 diameters was also smaller (p = 0.004) in IS than controls. Collectively, the spinal canal diameters in the IS were significantly different from controls (Friedman test p < 0.0001).


Patients with IS have abnormally narrow upper and mid cervical spinal canal diameters and greater positive tapering between C3 and C7.


Idiopathic syringomyelia Cerebrospinal fluid Cervical spinal canal CSF flow dynamics 



Idiopathic syringomyelia


Intra-class correlation coefficient


University of Wisconsin


Mayo Clinic


University of California San Francisco


University of California San Diego


Cerebrospinal fluid


Internal review board


Subarachnoid space


Interquartile range


Compliance with ethical standards

We declare that all human and animal studies have been approved by the respective internal review boards of Mayo Clinic, USA, University of California San Francisco, USA, University of California San Diego, USA, and the University of Wisconsin Madison, USA, and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.


  1. 1.
    Martin BA, Kalata W, Loth F, Royston TJ, Oshinski JN (2005) Syringomyelia hydrodynamics: an in vitro study based on in vivo measurements. J Biomech Eng 127(7):1110–1120CrossRefPubMedGoogle Scholar
  2. 2.
    Thompson A, Madan N, Hesselink JR, Weinstein G, Munoz Del Rio A, Haughton V (2015) The cervical spinal canal tapers differently in patients with Chiari I with and without syringomyelia. AJNR Am J Neuroradiol. doi: 10.3174/ajnr.A4597 PubMedCentralGoogle Scholar
  3. 3.
    Struck AF, Haughton VM (2009) Idiopathic syringomyelia: phase-contrast MR of cerebrospinal fluid flow dynamics at level of foramen magnum. Radiology 253(1):184–190. doi: 10.1148/radiol.2531082135 CrossRefPubMedGoogle Scholar
  4. 4.
    Bogdanov EI, Heiss JD, Mendelevich EG, Mikhaylov IM, Haass A (2004) Clinical and neuroimaging features of “idiopathic” syringomyelia. Neurology 62(5):791–794CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Iskandar BJ, Hedlund GL, Grabb PA, Oakes WJ (1998) The resolution of syringohydromyelia without hindbrain herniation after posterior fossa decompression. J Neurosurg 89(2):212–216. doi: 10.3171/jns.1998.89.2.0212 CrossRefPubMedGoogle Scholar
  6. 6.
    Hammersley J, Haughton V, Wang Y, del Rio AM (2012) Tapering of the cervical spinal canal in patients with scoliosis with and without the Chiari I malformation. AJNR Am J Neuroradiol 33(9):1752–1755. doi: 10.3174/ajnr.A3046 CrossRefPubMedGoogle Scholar
  7. 7.
    Friedman M (1940) A comparison of alternative tests of significance for the problem of m rankings. Ann Math Stat 11(1):86–92CrossRefGoogle Scholar
  8. 8.
    Dunn O (1961) Multiple comparisons among means. J Am Stat Assoc 56(293):52–64CrossRefGoogle Scholar
  9. 9.
    Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310CrossRefPubMedGoogle Scholar
  10. 10.
    Kendall M (1938) A new measure of rank correlation. Biometrika 30(1-2):81–89CrossRefGoogle Scholar
  11. 11.
    Ulbrich EJ, Schraner C, Boesch C, Hodler J, Busato A, Anderson SE, Eigenheer S, Zimmermann H, Sturzenegger M (2014) Normative MR cervical spinal canal dimensions. Radiology 271(1):172–182. doi: 10.1148/radiol.13120370 CrossRefPubMedGoogle Scholar
  12. 12.
    Shah S, Haughton V, del Rio AM (2011) CSF flow through the upper cervical spinal canal in Chiari I malformation. AJNR Am J Neuroradiol 32(6):1149–1153. doi: 10.3174/ajnr.A2460 CrossRefPubMedGoogle Scholar
  13. 13.
    Kato N, Tanaka T, Nagashima H, Arai T, Hasegawa Y, Tani S, Abe T (2010) Syrinx disappearance following laminoplasty in cervical canal stenosis associated with Chiari malformation—case report. Neurol Med Chir 50(2):172–174CrossRefGoogle Scholar
  14. 14.
    Martin BA, Labuda R, Royston TJ, Oshinski JN, Iskandar B, Loth F (2010) Spinal subarachnoid space pressure measurements in an in vitro spinal stenosis model: implications on syringomyelia theories. J Biomech Eng 132(11):111007. doi: 10.1115/1.4000089 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Aaron F. Struck
    • 1
  • Carrie M. Carr
    • 2
  • Vinil Shah
    • 3
  • John R. Hesselink
    • 4
  • Victor M. Haughton
    • 5
  1. 1.Department of NeurologyMassachusetts General HospitalBostonUSA
  2. 2.Department of RadiologyMayo ClinicRochesterUSA
  3. 3.Department of RadiologyUniversity of California San FranciscoSan FranciscoUSA
  4. 4.Department of RadiologyUniversity of California San DiegoSan DiegoUSA
  5. 5.Department of RadiologyUniversity of WisconsinMadisonUSA

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