Results 1 to 7 of 7

Thread: Chiari I / Syrinx?

  1. #1
    Join Date
    Nov 2006
    Posts
    1

    Exclamation Chiari I / Syrinx?

    I'm 16 and have been having monitoring for my scoliosis over the past two years, and it's slowly been getting to the point where surgery will probably be necessary. I had an MRI scan just to make sure everything's in working order -- and was later told that I also have a borderline chiari malformation type I and a small syrinx. Obviously, this complicates surgery and I'll probably have to have the decompression operation before spinal fusion, which is all pretty terrifying! I was really just wondering if anybody had any further information about the relationship between Chiari/syrinx and scoliosis? (I've been told that there is some connection, but we don't know much about it.)

    Also, something that I've noticed for a while is that the whole left side of my body is bigger than the right. At first I thought it was just me, then I thought it was part of my scoliosis, and now I'm just hoping it's not something more to worry about. My shoulders and hips are displaced as is normal with scoli, but also my left foot is bigger than my right, my left calf is 2cm fatter than my right (yes I measured :P), my left breast is quite a lot bigger than the right, and my left ear is about a centimetre bigger than my right. I haven't looked for anything else but I'm sure there are lots more discrepancies. Also when I swim, I drift off to one side and use one foot more than the other, and when I was a baby and started to crawl, I only used one leg for a while.

    Maybe this is just silly teenage paranoia or a normal part of scoliosis, but I'm slightly concerned that there's something else going on with my spine. Could anybody suggest anywhere for me to research? Or anything I should be doing? Obviously, I'll bring this up with my consultant next time I see him.

    Thank you!

  2. #2
    Join Date
    Sep 2006
    Posts
    416
    Lewa_14,

    I don't have any definitive answers to your questions... sounds like good food for thought for your consultant/Doctor. However I thought I would mention the following...

    There does seem to be a link between scoliosis and Chairi/syrinx, nobody seems to definitively know why. All that I can say is this: The curvatures found in scoliotic spines place a great deal of tension on the Dura surrounding the spine. This in turn can inhibit flow of cerebral spinal fluid (leading to cystic growth/syrinx) and will affect cranial structures in the head, including the cerebellum and tonsilar region.

    I have seen many people with uneven muscular development, both with and without scoliosis. It is not uncommon when an imbalance exists in the pelvis and/or spine. Given your scoliosis and current age (relative to the intense period of development) it is inevitable that you are placing different levels of demand on your body, left vs. right. Weight distribution, muscular coordination, gait pattern, etc. will all be affected. This can, and usually does lead to asymmetric growth and development (which can also further perpetuate the cycle) It can make one calf larger than the other, the arch of one foot will probably be positioned differently than the other, (is one of your arches on the inside of your feet closer/further from the ground than the other when standing barefoot? This will change the length of your foot.), position of the foot (Is one turned out to the side? Both? Inward? Straight forward?). Curvatures/rotations in the thoracic spine will alter the position of the shoulder girdles on the ribcage, thus resulting in irregular development of the chest muscles causing a breast to appear larger). Wherever the discrepancy might be, these 'could' be, in part, developmental functional by-products of compensations for the spine.

    As shown in your swimming, you have a very pronounced dominant side, and contrasting less active side. Again, probably a functional effect of the scoliosis. I've worked with some triathletes with scoliosis and they have presented with very pronounced asymmetries in regard to muscular development of the shoulders, legs and spine alike. They have all had 'drift' patterns in their swimming as well (tendancy to drift to one side).

    Of course, given the tendancy you described as an infant, some underlaying neurologic imbalance could be playing a significant role in all of this, leading to the same outcomes. I don't know 'why' it is the case for you personally, but it doesn't sound like you need to be overly-concerned about. Definitely mention it to your Doctor or neuroendocrinologist and take it from there. It's not uncommon.

    Best wishes, and I'm sure everything will go well for you.

    kind regards,
    structural

  3. #3
    Join Date
    Jan 2006
    Posts
    513
    Everyone is a bit lopsided with one foot and breast at least a bit different size than the other. And just as most people are right or left handed, we all have one side that is stonger than the other. I drift when I swim, too.( I don't have scoliosis, my daughter does.)
    Don't worry, but do ask.
    Hugs,
    Cheryl
    Last edited by cherylplinder; 11-30-2006 at 04:04 PM.
    God has used scoliosis to strengthen and mold us. He's good all the time!On this forum these larger curves have not held forever in Spinecor,with an initial positive response followed by deterioration. With deterioration, change treatment.The first year she gained 4 or 5 inches and was stable at around 20/20 in brace, followed by rapid progression the next year.She is now 51/40 (Jan2008)out of brace (40/30 in Spinecor) and started at 38/27 out of brace(Jan2006.) Now in Cheneau.

  4. #4
    Join Date
    Mar 2004
    Posts
    1,140
    Interesting....I didn't think I would have anything to offer to this discussion but the other day I was doing a pubmed search and remember coming across this abstract:


    1: Stud Health Technol Inform. 2006;123:391-7. Links

    Etiologic theories of idiopathic scoliosis: enantiomorph disorder concept of bilateral symmetry, physeally-created growth conflicts and possible prevention.

    Burwell RG, Freeman BJ, Dangerfield PH, Aujla RK, Cole AA, Kirby AS, Pratt RK, Webb JK, Moulton A.

    The Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham, UK.

    The detection of anomalous extra-spinal left-right skeletal length asymmetries in the upper limbs, periapical ribs, ilia and lower limbs of subjects with adolescent idiopathic scoliosis (AIS) raises questions about skeletal bilateral symmetry of vertebrates in health and disorder, its origin and control. The vertebrate body plan externally has mirror-image bilateral symmetries that are highly conserved culminating in the adult form. The normal human body can be viewed as containing paired skeletal structures in the axial and appendicular skeleton as 1) separate left and right paired forms (eg long limb bones, ribs, ilia), and 2) united in paired forms (eg vertebrae, sternum, skull, mandible). Each of these separate and united pairs are mirror-image forms--enantiomorphs. Left-right asymmetries of growth plates (physes) may cause (1) in long bones length asymmetries, (2) within one or more vertebral physes putative growth conflict with distortion as deformity, and (3) between ribs and vertebrae putative growth conflict that triggers thoracic AIS suggesting preventive surgery on spine and ribs. There is evidence of a possible role for environmental factors in AIS development. Genes and the environment (nature/nurture) may interact pre- and/or post-natally to explain both the deformity of AIS and its association with widespread anomalous skeletal length asymmetries. If substantiated there may ultimately be a place for the prevention of AIS in some subjects.

    PMID: 17108457 [PubMed - in process]

  5. #5
    Join Date
    Mar 2006
    Location
    DFW, TX
    Posts
    159

    Chiari I Malformation

    My 12 year old daughter will be going for Chiari I surgery on Monday, December 4th. She has scoliosis and is not a spinal fusion candidate yet, but needs the Chiari surgery as she has a large syrnix. I learned alot from the web and this is a great forum. I read this website www.asap.org . I hope that may give more information for you.

  6. #6
    Join Date
    Jun 2005
    Location
    Ohio
    Posts
    41
    I have both Chiari and Scoliosis, and my chiari is what caused my scoli. Everything on my left side is bigger too.... including my left leg (both calf and thigh ugh), which caused a limp. I had decompression surgery about a month ago, and it went extremely well. My surgeon thinks my chiari will be completely taken care of, and that in that in 6 months I can stop bracing forever!! (very exciting as I've been in a brace for 8 years). But since yours is borderline Chiari, I'm not sure they would do the decompression unless your scoliosis progresses enough to require it. Do you know how much your herniation is? Mine was 17mm, and I was told right away that I needed the surgery. If you do have to have the decompression, it isn't too terrible. I was sick for a while, and my neck was very tight, but looking back, I'm glad I did it. I feel great now, and I don't have to worry about what problems it might have caused in the future. Good luck!
    Scoliosis for 8 years, Milwaukee, Providence & Boston braces. 35T 42L Dx'd with Chiari Malformation 8/06, decompression surgery + duraplasty 11/24/06.

  7. #7
    Join Date
    Mar 2006
    Location
    DFW, TX
    Posts
    159

    Same having both and Chiari caused scoliosis

    Quote Originally Posted by drummergrl
    I have both Chiari and Scoliosis, and my chiari is what caused my scoli. Everything on my left side is bigger too.... including my left leg (both calf and thigh ugh), which caused a limp. I had decompression surgery about a month ago, and it went extremely well. My surgeon thinks my chiari will be completely taken care of, and that in that in 6 months I can stop bracing forever!! (very exciting as I've been in a brace for 8 years). But since yours is borderline Chiari, I'm not sure they would do the decompression unless your scoliosis progresses enough to require it. Do you know how much your herniation is? Mine was 17mm, and I was told right away that I needed the surgery. If you do have to have the decompression, it isn't too terrible. I was sick for a while, and my neck was very tight, but looking back, I'm glad I did it. I feel great now, and I don't have to worry about what problems it might have caused in the future. Good luck!
    Glad you are doing well. My daughter is recovering well from Chiari surgery. 3 orthopedics and neurologists aren't sure any brace will stop rapid curve progression, and say it won't hurt to continue brace. She was only on pain meds 4 days,the 4 days in hospital. Not even tylenol now, and only slight tenderness on incision when washing it. She had a large pocket of fluid so it was necessary. She is doing well. Surgery for chiari decompression very good statistical results for children. Hope this info is useful to you somehow.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •