Tags

Type your tag names separated by a space and hit enter

Surgical results of arachnoid-preserving posterior fossa decompression for Chiari I malformation with associated syringomyelia.
J Clin Neurosci. 2012 Apr; 19(4):557-60.JC

Abstract

We analyzed the outcome of posterior fossa decompression accompanied by widening of the cisterna magna, without disturbing the arachnoid, in patients with Chiari I malformation (CMI) associated with syringomyelia. Twenty-five adult patients with CMI and syringomyelia, who underwent surgery between October 2000 and December 2008, were enrolled in this study. All patients underwent foramen magnum decompression with C1 decompression, with or without C2 decompression. Three surgeons performed a dura opening with duraplasty in 20 patients, and another surgeon excised the outer layer of the dura without duraplasty in five patients. Clinical and radiological assessments were performed preoperatively and during the follow-up period. After surgery, 20 (80%) patients achieved a significant improvement in their clinical symptoms. However, four patients (16%) achieved only a stable state, and one patient's symptoms worsened. Radiological analysis showed that 17 patients (68%) had a favorable result; that is, a total collapse, or a marked reduction, of the syrinx. Seven patients (28%) were stable in terms of syrinx size. However, the syrinx enlarged in one patient who had undergone excision of the outer dura. Twenty-four patients achieved a widened cisterna magna with ascent of the cerebellar tonsils into the posterior fossa and acquisition of a more rounded shape. Postoperative complications included a transient headache and vomiting in three patients and transient motor weakness in one patient. Two patients developed a superficial wound infection. This study shows that arachnoid-preserving posterior fossa decompression is a safe and effective treatment for patients with CMI with associated syringomyelia.

Authors+Show Affiliations

Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22300790

Citation

Lee, Hyun Seok, et al. "Surgical Results of Arachnoid-preserving Posterior Fossa Decompression for Chiari I Malformation With Associated Syringomyelia." Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, vol. 19, no. 4, 2012, pp. 557-60.
Lee HS, Lee SH, Kim ES, et al. Surgical results of arachnoid-preserving posterior fossa decompression for Chiari I malformation with associated syringomyelia. J Clin Neurosci. 2012;19(4):557-60.
Lee, H. S., Lee, S. H., Kim, E. S., Kim, J. S., Lee, J. I., Shin, H. J., & Eoh, W. (2012). Surgical results of arachnoid-preserving posterior fossa decompression for Chiari I malformation with associated syringomyelia. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, 19(4), 557-60. https://doi.org/10.1016/j.jocn.2011.06.034
Lee HS, et al. Surgical Results of Arachnoid-preserving Posterior Fossa Decompression for Chiari I Malformation With Associated Syringomyelia. J Clin Neurosci. 2012;19(4):557-60. PubMed PMID: 22300790.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical results of arachnoid-preserving posterior fossa decompression for Chiari I malformation with associated syringomyelia. AU - Lee,Hyun Seok, AU - Lee,Sun-Ho, AU - Kim,Eun Sang, AU - Kim,Jong-Soo, AU - Lee,Jung-Il, AU - Shin,Hyung Jin, AU - Eoh,Whan, Y1 - 2012/02/01/ PY - 2011/05/02/received PY - 2011/06/26/accepted PY - 2012/2/4/entrez PY - 2012/2/4/pubmed PY - 2012/6/16/medline SP - 557 EP - 60 JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia JO - J Clin Neurosci VL - 19 IS - 4 N2 - We analyzed the outcome of posterior fossa decompression accompanied by widening of the cisterna magna, without disturbing the arachnoid, in patients with Chiari I malformation (CMI) associated with syringomyelia. Twenty-five adult patients with CMI and syringomyelia, who underwent surgery between October 2000 and December 2008, were enrolled in this study. All patients underwent foramen magnum decompression with C1 decompression, with or without C2 decompression. Three surgeons performed a dura opening with duraplasty in 20 patients, and another surgeon excised the outer layer of the dura without duraplasty in five patients. Clinical and radiological assessments were performed preoperatively and during the follow-up period. After surgery, 20 (80%) patients achieved a significant improvement in their clinical symptoms. However, four patients (16%) achieved only a stable state, and one patient's symptoms worsened. Radiological analysis showed that 17 patients (68%) had a favorable result; that is, a total collapse, or a marked reduction, of the syrinx. Seven patients (28%) were stable in terms of syrinx size. However, the syrinx enlarged in one patient who had undergone excision of the outer dura. Twenty-four patients achieved a widened cisterna magna with ascent of the cerebellar tonsils into the posterior fossa and acquisition of a more rounded shape. Postoperative complications included a transient headache and vomiting in three patients and transient motor weakness in one patient. Two patients developed a superficial wound infection. This study shows that arachnoid-preserving posterior fossa decompression is a safe and effective treatment for patients with CMI with associated syringomyelia. SN - 1532-2653 UR - https://www.unboundmedicine.com/medline/citation/22300790/Surgical_results_of_arachnoid_preserving_posterior_fossa_decompression_for_Chiari_I_malformation_with_associated_syringomyelia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0967-5868(11)00595-9 DB - PRIME DP - Unbound Medicine ER -