Appropriate surgical procedures for Chiari type 1 malformation and associated syrinx based on radiological characteristics of the craniovertebral junction.

07:00 EST 25th January 2019 | BioPortfolio

Summary of "Appropriate surgical procedures for Chiari type 1 malformation and associated syrinx based on radiological characteristics of the craniovertebral junction."

Several surgical procedures can be applied for syrinx associated with Chiari type 1 malformation; however, it remains controversial as to which approach is the most effective. Here, we evaluated the indications and limitations of foramen magnum decompression (FMD) with or without dural plasty. Forty patients with Chiari type 1 malformation were surgically treated and followed up for > 12 months. Thirty-two patients (80.0%) underwent FMD with removal of only the outer dura mater layer, while eight patients underwent FMD with dural plasty. We evaluated surgery-related complications and preoperative radiological findings affecting syrinx shrinkage rates. Post-surgery, the mean syrinx shrinkage rates were 0.32 ± 0.44 in the outer layer-removal group and 0.72 ± 0.27 in the dural plasty group (P = 0.012). Surgery-related complications were less frequent, but reoperation was more frequent, in the outer layer-removal group. The extent of tonsillar descent significantly affected syrinx shrinkage in FMD with outer layer removal (P = 0.042). The outcomes of both approaches in patients with tonsillar descent < 10.0 mm were similar. The dura mater in the posterior fossa was thin, necessitating dural plasty with FMD, while the spinal dura was sufficiently thick for removal of the outer layer in the Chiari patients. These histological differences corresponded with the inferior margin of the cerebellar tonsil. Recognizing the appropriate surgical indication for achieving good post-procedural outcomes is necessary for reducing complications and improving outcomes of FMD for Chiari type 1 malformations.


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This article was published in the following journal.

Name: Neurosurgical review
ISSN: 1437-2320


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Medical and Biotech [MESH] Definitions

Surgical procedures performed using a computer that remotely controls surgical instruments attached to mechanical arms designed to perform the tasks of the surgeon.

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Surgical procedures done to prevent or reduce the risk of developing cancer or other disease conditions in persons who may be predisposed to such conditions.

Surgery restricted to the management of minor problems and injuries; surgical procedures of relatively slight extent and not in itself hazardous to life. (Dorland, 28th ed & Stedman, 25th ed)

Surgical techniques in which SUTURES are not applied to surgical wounds.

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