Holocord Syrinx Following Childhood Traumatic Spinal Cord Injury – A 25-year Delayed Presentation

Holocord syringomyelia is a rare complication following spinal cord injury, characterized by a syrinx extending the entire length of the spinal cord. This case report presents a 45-year-old male who developed symptoms 25 years after a childhood spinal injury, manifesting as burning pain and sensory deficits without motor weakness. MRI revealed a holocord syrinx from C1 to the conus in association with an old L1 fracture and cord compression. The patient underwent posterior decompression and stabilization without shunt placement, leading to improvement in sensory symptoms. Literature review highlights that holocord syrinx can arise decades after trauma and poses diagnostic and therapeutic challenges. Management strategies focus on restoring cerebrospinal fluid dynamics and relieving cord compression, and outcomes vary between surgical approaches. Intensive postoperative rehabilitation is crucial for recovery. Early recognition, individualized treatment, and multidisciplinary follow-up are essential for optimizing outcomes in holocord syringomyelia after spinal cord injury.