Comparison decompression by duraplasty or cerebellar tonsillectomy for Chiari malformation-I complicated with syringomyelia

• Published in: Clinical neurology and neurosurgery 2019-01, Vol.176, p.1-7
• Main Authors: Jia, Chong, li, Hongwei, Wu, Junru, Gao, Kun, Zhao, Cheng Bin, Li, Mu, Sun, Xiang, Yang, Bo
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Aged; Arnold-Chiari Malformation - complications; Arnold-Chiari Malformation - surgery; Ataxia; Atrophy; Brain; Cerebellum; Chiari malformation type I; Complications; Congenital defects; Cranial Fossa, Posterior - surgery; Decompression; Decompression, Surgical - methods; Dura mater; Dura Mater - surgery; Duraplasty; Dysphagia; Female; Gait; Headache; Headaches; Humans; Inflammation; Male; Middle Aged; Neural tube defects; Neurology; Neurosurgical Procedures; NMR; Nuclear magnetic resonance; Outcome; Pain; Patients; Posterior fossa decompression; Postoperative Complications; Reconstructive Surgical Procedures; Scoliosis; Spinal cord; Syringomyelia - complications; Syringomyelia - surgery; Syrinx; Throat surgery; Young Adult
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2018.11.008

•115 cases of CM-I patients underwent the surgical procedure for treatment.•The two methods surgical approach has the same therapeutic effect.•PFDRT leads to higher complication rates resulted from aseptic inflammation.•Preoperative cavity of >30% could as a predictor of better outcome. The current study aimed to assess the two surgical procedures of posterior fossa decompression (PDF) in treating Chiari malformation type I (CM-1) complicated by syringomyelia (SM), and to evaluate the postoperative complications, surgical effects and prognosis. A retrospective study was performed on 115 adult CM-I patients undergoing surgical treatment from November 2013 to November 2016 in a single comprehensive hospital. These patients underwent the surgical procedure of either posterior fossa decompression with duraplasty (PFDD) or posterior fossa decompression combined with the resection of tonsils (PFDRT) by five experienced neurosurgeon in a single center. The clinical outcomes of these two surgical procedures were evaluated through comparing the clinical data before and 6 months after the operation. A total of 115 patients, including 35 men and 80 women with the mean age of 43.4 ± 10.1 years (range, 16–60 years), were enrolled in the current study. 37 out of the 115 patients underwent PFDD, while the remaining 78 received PFDRT according to the surgical assessment. The operation time in PFDRT group (159.3 ± 40.0 min) was higher than that in PFDD group (134.1 ± 30.8 min) (P