Syringomyelia is formation of a long cystic cavity in the spinal cord .The cavity, called as syrinx, expands and elongates over time, destroying a portion of the spinal cord from its centre and expanding outward. Neuraxial block in a patient with syringomyelia will cause sudden changes in CSF pressure leading to sudden worsening of signs and symptoms. We describe successful distal femur plating performed under extradural anaesthesia in an 82 years male patient with a traumatic, non-communicating, syringomyelia from D2 to D9, chronic obstructive pulmonary disease, weak intercostal muscles due to cervico dorsal injury and hiatus hernia causing chronic cough.