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Decompression for Chiari type I-malformation (with or without syringomyelia) by extreme lateral foramen magnum opening and expansile duraplasty with arachnoid preservation: comparison with other technical modalities (Literature review).
Adv Tech Stand Neurosurg. 2009; 34:85-110.AT

Abstract

Posterior craniocervical decompression is the procedure most currently used for treating Chiari I malformation (alone or in association with syringomyelia in the absence of hydrocephalus). We reviewed the various technical modalities reported in the literature. We present a personal series of 44 patients harboring Chiari type I malformation (CM-I) operated with a suboccipital craniectomy and a C1 (or C1/C2) laminectomy, plus an extreme lateral Foramen Magnum opening, a "Y" shaped dural incision with preservation of the arachnoid membrane, and an expansile duraplasty employing autogenous periosteum. Outcomes were analyzed with follow-up ranging from 1 to 10 years (4 years on average). The presented technique was compared with the other surgical modalities reported in the literature. This comparative study shows that this type of craniocervical decompression achieved the best results with minimal complications and side-effects. Syringomyelia associated with CM-I must be treated by craniocervical decompression alone. Shunting no longer appears to be an appropriate method of treatment for syringomyelia.

Authors+Show Affiliations

Department of Neurosurgery, Hôpital Neurologique Pierre Wertheimer, University of Lyon, Lyon, France.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19368082

Citation

Sindou, M, and E Gimbert. "Decompression for Chiari Type I-malformation (with or Without Syringomyelia) By Extreme Lateral Foramen Magnum Opening and Expansile Duraplasty With Arachnoid Preservation: Comparison With Other Technical Modalities (Literature Review)." Advances and Technical Standards in Neurosurgery, vol. 34, 2009, pp. 85-110.
Sindou M, Gimbert E. Decompression for Chiari type I-malformation (with or without syringomyelia) by extreme lateral foramen magnum opening and expansile duraplasty with arachnoid preservation: comparison with other technical modalities (Literature review). Adv Tech Stand Neurosurg. 2009;34:85-110.
Sindou, M., & Gimbert, E. (2009). Decompression for Chiari type I-malformation (with or without syringomyelia) by extreme lateral foramen magnum opening and expansile duraplasty with arachnoid preservation: comparison with other technical modalities (Literature review). Advances and Technical Standards in Neurosurgery, 34, 85-110.
Sindou M, Gimbert E. Decompression for Chiari Type I-malformation (with or Without Syringomyelia) By Extreme Lateral Foramen Magnum Opening and Expansile Duraplasty With Arachnoid Preservation: Comparison With Other Technical Modalities (Literature Review). Adv Tech Stand Neurosurg. 2009;34:85-110. PubMed PMID: 19368082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decompression for Chiari type I-malformation (with or without syringomyelia) by extreme lateral foramen magnum opening and expansile duraplasty with arachnoid preservation: comparison with other technical modalities (Literature review). AU - Sindou,M, AU - Gimbert,E, PY - 2009/4/17/entrez PY - 2009/4/17/pubmed PY - 2009/5/9/medline SP - 85 EP - 110 JF - Advances and technical standards in neurosurgery JO - Adv Tech Stand Neurosurg VL - 34 N2 - Posterior craniocervical decompression is the procedure most currently used for treating Chiari I malformation (alone or in association with syringomyelia in the absence of hydrocephalus). We reviewed the various technical modalities reported in the literature. We present a personal series of 44 patients harboring Chiari type I malformation (CM-I) operated with a suboccipital craniectomy and a C1 (or C1/C2) laminectomy, plus an extreme lateral Foramen Magnum opening, a "Y" shaped dural incision with preservation of the arachnoid membrane, and an expansile duraplasty employing autogenous periosteum. Outcomes were analyzed with follow-up ranging from 1 to 10 years (4 years on average). The presented technique was compared with the other surgical modalities reported in the literature. This comparative study shows that this type of craniocervical decompression achieved the best results with minimal complications and side-effects. Syringomyelia associated with CM-I must be treated by craniocervical decompression alone. Shunting no longer appears to be an appropriate method of treatment for syringomyelia. SN - 0095-4829 UR - https://www.unboundmedicine.com/medline/citation/19368082/Decompression_for_Chiari_type_I_malformation__with_or_without_syringomyelia__by_extreme_lateral_foramen_magnum_opening_and_expansile_duraplasty_with_arachnoid_preservation:_comparison_with_other_technical_modalities__Literature_review__ L2 - http://www.diseaseinfosearch.org/result/6981 DB - PRIME DP - Unbound Medicine ER -