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Posterior fossa decompression in syringomyelia associated with a Chiari malformation: a retrospective analysis of 22 patients.
Clin Neurol Neurosurg. 2000 Jun; 102(2):91-6.CN

Abstract

BACKGROUND

The technique of posterior fossa decompression, nowadays preferred by most neurosurgeons as the first surgical option in the treatment of hindbrain associated syringomyelia, was reintroduced in our center in 1989. We present a retrospective analysis of 22 patients with this pathology who underwent the procedure since then.

METHODS

In all patients diagnosis was made by MRI of the craniospinal junction. The operation consisted of a suboccipital craniectomy, removal of the posterior arc of C1, laminectomy of C2 or C3 when necessary and a wide duraplasty at the end. The intradural manipulations (opening of the arachnoid membrane, coagulation or resection of the tonsils) were not uniform. Postoperatively short- and long-term clinical outcome and MRI findings were assessed.

RESULTS

Sixteen out of 21 patients (76%) experienced an improvement in the early follow-up period. In the late follow-up period 13 out of 19 patients (68%) were improved, whereas five patients (26%) experienced a marked deterioration. There was no unequivocal effect on all symptoms and signs. Postoperative MR images showed a favorable result in 16 out of 20 patients (80%), consisting of syrinx collapse or reduction of the syrinx diameter.

CONCLUSIONS

We conclude that decompression of the posterior fossa is a safe procedure with a considerable chance of clinical improvement. Although total syrinx collapse is not as frequently seen as in syrinx shunting procedures, the clinical outcome may be better. Moreover, there seemed to be no unequivocal correlation between clinical outcome and postoperative syrinx size in the present study.

Authors+Show Affiliations

Department of Neurosurgery, University Hospital Gasthuisberg, Catholic University of Leuven, Herestraat 49, B-3000, Leuven, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10817895

Citation

Depreitere, B, et al. "Posterior Fossa Decompression in Syringomyelia Associated With a Chiari Malformation: a Retrospective Analysis of 22 Patients." Clinical Neurology and Neurosurgery, vol. 102, no. 2, 2000, pp. 91-6.
Depreitere B, Van Calenbergh F, van Loon J, et al. Posterior fossa decompression in syringomyelia associated with a Chiari malformation: a retrospective analysis of 22 patients. Clin Neurol Neurosurg. 2000;102(2):91-6.
Depreitere, B., Van Calenbergh, F., van Loon, J., Goffin, J., & Plets, C. (2000). Posterior fossa decompression in syringomyelia associated with a Chiari malformation: a retrospective analysis of 22 patients. Clinical Neurology and Neurosurgery, 102(2), 91-6.
Depreitere B, et al. Posterior Fossa Decompression in Syringomyelia Associated With a Chiari Malformation: a Retrospective Analysis of 22 Patients. Clin Neurol Neurosurg. 2000;102(2):91-6. PubMed PMID: 10817895.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Posterior fossa decompression in syringomyelia associated with a Chiari malformation: a retrospective analysis of 22 patients. AU - Depreitere,B, AU - Van Calenbergh,F, AU - van Loon,J, AU - Goffin,J, AU - Plets,C, PY - 2000/5/19/pubmed PY - 2000/8/29/medline PY - 2000/5/19/entrez SP - 91 EP - 6 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 102 IS - 2 N2 - BACKGROUND: The technique of posterior fossa decompression, nowadays preferred by most neurosurgeons as the first surgical option in the treatment of hindbrain associated syringomyelia, was reintroduced in our center in 1989. We present a retrospective analysis of 22 patients with this pathology who underwent the procedure since then. METHODS: In all patients diagnosis was made by MRI of the craniospinal junction. The operation consisted of a suboccipital craniectomy, removal of the posterior arc of C1, laminectomy of C2 or C3 when necessary and a wide duraplasty at the end. The intradural manipulations (opening of the arachnoid membrane, coagulation or resection of the tonsils) were not uniform. Postoperatively short- and long-term clinical outcome and MRI findings were assessed. RESULTS: Sixteen out of 21 patients (76%) experienced an improvement in the early follow-up period. In the late follow-up period 13 out of 19 patients (68%) were improved, whereas five patients (26%) experienced a marked deterioration. There was no unequivocal effect on all symptoms and signs. Postoperative MR images showed a favorable result in 16 out of 20 patients (80%), consisting of syrinx collapse or reduction of the syrinx diameter. CONCLUSIONS: We conclude that decompression of the posterior fossa is a safe procedure with a considerable chance of clinical improvement. Although total syrinx collapse is not as frequently seen as in syrinx shunting procedures, the clinical outcome may be better. Moreover, there seemed to be no unequivocal correlation between clinical outcome and postoperative syrinx size in the present study. SN - 0303-8467 UR - https://www.unboundmedicine.com/medline/citation/10817895/Posterior_fossa_decompression_in_syringomyelia_associated_with_a_Chiari_malformation:_a_retrospective_analysis_of_22_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(00)00073-1 DB - PRIME DP - Unbound Medicine ER -