Post Spinal Anesthesia Syrinx-MRI

This is 25 year old who was operated for appendicitis in the peripheral centre followed by right sided monoparesis. MRI revealed focal syrinx-myelomalacia at D11-L1 levels towards right side. Attempting to use higher lumbar intervertebral spaces for access to the subarachnoid space or epidural space may lead to inadvertent puncture of the lower dorsal spaces; this makes the procedure of spinal anesthesia at this level prone for spinal cord injury, with subsequent risk of development of myelomalacic syrinx in the conus and epiconus region of the spinal cord.