Asian Spine J.  2015 Oct;9(5):721-727. 10.4184/asj.2015.9.5.721.

Foramen Magnum Decompression and Duraplasty is Superior to Only Foramen Magnum Decompression in Chiari Malformation Type 1 Associated with Syringomyelia in Adults

Affiliations
  • 1Neurosurgery Clinic, Emsey Hospital, Istanbul, Turkey. mehmetsabrigurbuz@gmail.com
  • 2Neurosurgery Clinic, Acibadem Hospital, Istanbul, Turkey.
  • 3Neurosurgery Clinic, Agri Public Hospital, Agri, Turkey.
  • 4Neurosurgery Clinic, Sanliurfa Public Hospital, Sanliurfa, Turkey.
  • 5Department of Neurosurgery, Haydarpasa Numune Training Hospital, Istanbul, Turkey.

Abstract

STUDY DESIGN: Retrospective cohort study. PURPOSE: To compare surgical results of foramen magnum decompression with and without duraplasty in Chiari malformation type 1 (CM-1) associated syringomyelia (SM). OVERVIEW OF LITERATURE: The optimal surgical treatment of CM-1 associated with SM is unclear.
METHODS
Twenty-five cases of CM-1 with SM were included. There were 12 patients (48%) in the non-duraplasty group and 13 patients (52%) in the duraplasty group. The rate of improvement, state of postoperative SM size, amount of tonsillar herniation, preoperative symptom duration, complications and reoperation rates were analysed.
RESULTS
The rate of clinical improvement was significantly higher with duraplasty (84.6%) than without (33.3%, p <0.05). The rate of postoperative syrinx regression was significantly higher in the duraplasty group (84.6%) than in the non-duraplasty group (33.3%, p <0.05). One case in the duraplasty group needed a reoperation compared with five cases in the non-duraplasty group (p =0.059).
CONCLUSIONS
Duraplasty is superior to non-duraplasty in CM-1 associated with SM despite a slightly higher complication rate.

Keyword

Chiari malformation type 1; Syringomyelia; Duraplasty; Non-duraplasty; Foramen magnum decompression

MeSH Terms

Adult*
Cohort Studies
Decompression*
Encephalocele
Foramen Magnum*
Humans
Reoperation
Retrospective Studies
Syringomyelia*
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