• Juan C Vicenty-Padilla and Orlando De Jesus.
• Neurosurgery Section, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico, USA. Electronic address: juan.vicenty@upr.edu.
• World Neurosurg. 2018 Oct 1; 118: 240-242.

BackgroundSyringomyelia in the cervical spinal cord is a complex pathology that is commonly associated with Chiari I malformation or spinal cord trauma. In both cases the development of syringomyelia has been linked to multiple anatomic and molecular elements including epidural compression. Literature has mainly reported posterior cervical decompressive procedures or shunting of the cyst as options to address this pathology. Anterior decompression is rarely recommended.Case DescriptionWe present the case of a 19-year-old female who suffered a motor vehicle accident causing a cervical subluxation with mild new-onset neurologic deficits. Preoperative workup showed a large incidental cervical syringomyelia associated with a Chiari I malformation. Anterior cervical decompression at the subluxated cervical segment with a concomitant anterior and posterior fusion was performed. Postoperative workup revealed a significant interval reduction in the size of the syrinx cavity with concomitant neurologic improvement.ConclusionsAnterior decompression may be considered as an option in select cases of syringomyelia. The findings of this case support the theory of epidural compression as one of the inciting events for the development of syringomyelia.Published by Elsevier Inc.

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