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Syringomyelia associated with type I Chiari malformation. A 21-year retrospective study on 75 cases treated by foramen magnum decompression with a special emphasis on the value of tonsils resection.
Acta Neurochir (Wien). 1998; 140(8):745-54.AN

Abstract

The purpose of the present study is to evaluate retrospectively the effects of several intra-operative manipulations on the results of foramen magnum decompression (FMD) in patients having syringomyelia associated with type I Chiari malformation. Seventy-five patients having syringomyelia associated with Chiari I malformation were operated on between 1975 and 1996. This population was grouped into 4 subgroups according to the surgical protocol: group I = 42 patients with FMD alone; group II = 16 patients with FMD and third ventricle shunting; group III = 9 patients with FMD and syringosubarachnoid shunting (SSS); group IV = 8 patients with FMD and cerebellar tonsils resection. Pre- and postsurgical magnetic resonance imaging (MRI) studies were analyzed (and compared). Nine patients were lost to follow-up. The results were evaluated in the 66 remaining patients (mean follow-up: 52 months), using the Bidzinski's outcome scale (ref). Two patients (3%) died postoperatively, 31 (47%) had very good results (after additional surgery in 7), 16 (24.2%) had good results (after additional surgery in 7) and 17 (25.7%) had poor results despite further surgery in 9. A total of 27 reoperations were undertaken after primary FMD in 23 patients (35%). Thirty-nine patients (59%) had both pre- and postsurgical MRI evaluation. In 28 (72%) the syrinx had markedly decreased whereas it had remained stable in 11 (28%). Clinical results were not significantly different between the patients of groups I, II and III. Very good or good results were obtained in 24 patients (64.8%) of group I (after additional surgery in 10), in 8 (61.5%) of group II (after additional surgery in 1) and in 7 (87.5%) of group III (after additional surgery in 3). Results in group IV were as follows: 7 patients (87%) had very good results and one had a good result. With a mean follow-up of 28 months, no patient required additional surgery. Postsurgical MRI syrinx reduction was observed in all 8 patients either in the early postoperative course or on delayed followup. It is suggested that tonsils resection might enhance the results of FMD in individuals having Chiari I-related syringomyelia.

Authors+Show Affiliations

Service de Neurochirurgie, B-Hôpital Neurologique et Neurochirurgical P. Wertheimer, Lyon, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9810440

Citation

Guyotat, J, et al. "Syringomyelia Associated With Type I Chiari Malformation. a 21-year Retrospective Study On 75 Cases Treated By Foramen Magnum Decompression With a Special Emphasis On the Value of Tonsils Resection." Acta Neurochirurgica, vol. 140, no. 8, 1998, pp. 745-54.
Guyotat J, Bret P, Jouanneau E, et al. Syringomyelia associated with type I Chiari malformation. A 21-year retrospective study on 75 cases treated by foramen magnum decompression with a special emphasis on the value of tonsils resection. Acta Neurochir (Wien). 1998;140(8):745-54.
Guyotat, J., Bret, P., Jouanneau, E., Ricci, A. C., & Lapras, C. (1998). Syringomyelia associated with type I Chiari malformation. A 21-year retrospective study on 75 cases treated by foramen magnum decompression with a special emphasis on the value of tonsils resection. Acta Neurochirurgica, 140(8), 745-54.
Guyotat J, et al. Syringomyelia Associated With Type I Chiari Malformation. a 21-year Retrospective Study On 75 Cases Treated By Foramen Magnum Decompression With a Special Emphasis On the Value of Tonsils Resection. Acta Neurochir (Wien). 1998;140(8):745-54. PubMed PMID: 9810440.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Syringomyelia associated with type I Chiari malformation. A 21-year retrospective study on 75 cases treated by foramen magnum decompression with a special emphasis on the value of tonsils resection. AU - Guyotat,J, AU - Bret,P, AU - Jouanneau,E, AU - Ricci,A C, AU - Lapras,C, PY - 1998/11/12/pubmed PY - 2000/5/8/medline PY - 1998/11/12/entrez SP - 745 EP - 54 JF - Acta neurochirurgica JO - Acta Neurochir (Wien) VL - 140 IS - 8 N2 - The purpose of the present study is to evaluate retrospectively the effects of several intra-operative manipulations on the results of foramen magnum decompression (FMD) in patients having syringomyelia associated with type I Chiari malformation. Seventy-five patients having syringomyelia associated with Chiari I malformation were operated on between 1975 and 1996. This population was grouped into 4 subgroups according to the surgical protocol: group I = 42 patients with FMD alone; group II = 16 patients with FMD and third ventricle shunting; group III = 9 patients with FMD and syringosubarachnoid shunting (SSS); group IV = 8 patients with FMD and cerebellar tonsils resection. Pre- and postsurgical magnetic resonance imaging (MRI) studies were analyzed (and compared). Nine patients were lost to follow-up. The results were evaluated in the 66 remaining patients (mean follow-up: 52 months), using the Bidzinski's outcome scale (ref). Two patients (3%) died postoperatively, 31 (47%) had very good results (after additional surgery in 7), 16 (24.2%) had good results (after additional surgery in 7) and 17 (25.7%) had poor results despite further surgery in 9. A total of 27 reoperations were undertaken after primary FMD in 23 patients (35%). Thirty-nine patients (59%) had both pre- and postsurgical MRI evaluation. In 28 (72%) the syrinx had markedly decreased whereas it had remained stable in 11 (28%). Clinical results were not significantly different between the patients of groups I, II and III. Very good or good results were obtained in 24 patients (64.8%) of group I (after additional surgery in 10), in 8 (61.5%) of group II (after additional surgery in 1) and in 7 (87.5%) of group III (after additional surgery in 3). Results in group IV were as follows: 7 patients (87%) had very good results and one had a good result. With a mean follow-up of 28 months, no patient required additional surgery. Postsurgical MRI syrinx reduction was observed in all 8 patients either in the early postoperative course or on delayed followup. It is suggested that tonsils resection might enhance the results of FMD in individuals having Chiari I-related syringomyelia. SN - 0001-6268 UR - https://www.unboundmedicine.com/medline/citation/9810440/Syringomyelia_associated_with_type_I_Chiari_malformation__A_21_year_retrospective_study_on_75_cases_treated_by_foramen_magnum_decompression_with_a_special_emphasis_on_the_value_of_tonsils_resection_ L2 - https://dx.doi.org/10.1007/s007010050175 DB - PRIME DP - Unbound Medicine ER -