Syringomyelia or syrinx is a fluid-filled cavitation within the spinal cord that can produce symptoms of progressive myelopathy.1 Standard of care for large, symptomatic lesions involves direct surgical intervention. Here, we present a case of a woman who achieved spontaneous resolution of her cervicothoracic syrinx after significant weight loss.
A morbidly obese 42-year-old woman with body mass index (BMI) of 52 kg/m2 presented with months of progressive radiating pain to the hands. The patient described intermittent paresthesia and loss of temperature sensation in the left-greater-than-right hands. She had slight incoordination and weakness of the left hand, but was otherwise motor intact. She denied issues with gait instability or bowel/bladder incontinence. She had no antecedent history of trauma nor vision loss/symptoms of idiopathic intracranial hypertension (IIH).
MRI of the cervical, thoracic and lumbar spine without contrast revealed a large, cervical and thoracic syrinx, measuring 14 mm in the greatest…