Evaluation of operative procedures for symptomatic outcome after decompression surgery for Chiari type i malformation

Samuel Kalb, Luis Perez-Orribo, Mark Mahan, Nicholas Theodore, Peter Nakaji, Ruth E. Bristol

Research output: Contribution to journalArticle

Abstract

The wide spectrum of symptoms and radiographic findings in patients with Chiari I malformation makes the decision to proceed with intervention controversial. We evaluated symptomatic outcomes using diverse surgical techniques in 104 patients who underwent decompression surgery. The symptoms of most patients improved. Patients with syringomyelia showed less symptomatic improvement; however, syringomyelia was not associated with postoperative symptomatic worsening. Durotomy was performed in 97.1% and arachnoid opening was performed in 60.6% with visualization of the fourth ventricle in 51.9% of patients. Neither arachnoid opening nor fourth ventricle visualization was associated with the clinical outcome. Duraplasty was performed in 94.2% of patients. A Chiari plate was used in 13.4% of patients and was associated with favorable outcomes. Use of postoperative steroids or muscle relaxants was not associated with outcome. Syringomyelia showed a 62.5% improvement rate on postoperative MRI. In conclusion, bony decompression and dural opening are important aspects of Chiari I surgery, with symptomatic improvement observed in most patients.

Original languageEnglish (US)
Pages (from-to)1268-1272
Number of pages5
JournalJournal of Clinical Neuroscience
Volume19
Issue number9
DOIs
StatePublished - Sep 1 2012
Externally publishedYes

Keywords

  • Arachnoid
  • Chiari I malformation
  • Decompression
  • Duraplasty
  • Outcome

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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