Posterior Calvarial Augmentation for Chiari Malformation Type 1 Refractory to Foramen Magnum Decompression

2020 ◽  
Vol 139 ◽  
pp. 70-74 ◽  
Author(s):  
Fardad T. Afshari ◽  
Guirish A. Solanki ◽  
William B. Lo ◽  
Desiderio Rodrigues
Keyword(s):  
Chiari Malformation ◽  
Foramen Magnum ◽  
Foramen Magnum Decompression ◽  
Chiari Malformation Type 1

scholarly journals Foramen Magnum Decompression and Duraplasty is Superior to Only Foramen Magnum Decompression in Chiari Malformation Type 1 Associated with Syringomyelia in Adults

2015 ◽  
Vol 9 (5) ◽  
pp. 721 ◽  
Author(s):  
Mehmet Sabri Gürbüz ◽  
Mehmet Zafer Berkman ◽  
Emre Ünal ◽  
Elif Akpınar ◽  
Şevki Gök ◽  
...  
Keyword(s):  
Chiari Malformation ◽  
Foramen Magnum ◽  
Foramen Magnum Decompression ◽  
Chiari Malformation Type 1

scholarly journals Clinical outcome following duraplasty in type 1 Arnold Chiari malformation

2019 ◽  
Vol 6 (3) ◽  
pp. 857
Author(s):  
Guruprasad Bettaswamy ◽  
Rajesh R. Raykar ◽  
Rajesh Kumar Singh ◽  
Mahendra M.
Keyword(s):  
Clinical Outcome ◽  
Neck Pain ◽  
Clinical Improvement ◽  
Chiari Malformation ◽  
Foramen Magnum ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Improvement Rate ◽  
Female Ratio

Background: Few authors support the use of duraplasty and few authors have reported a higher rate of complications associated with the same. The objective of the present endeavor was to study clinical outcome following duraplasty in type 1 Arnold Chiari malformation.Methods: Retrospectively, 24 cases and prospectively 18 cases diagnosed and operated for Chiari malformation type I were included. Patients with Chiari type II, III, and IV were excluded. A questionnaire was used to assess the improvement in neck pain and disability due to it, head pain and disability due to it and improvement in general health before and one year after surgery. The results of the questionnaire of both groups were analyzed and compared.Results: The most common age group of presentation was 2nd decade (35.71%) followed by 3rd decade (26.19%). The male to female ratio was 1.2:1. The most common presenting complaint was sensory disturbances (66.66%) followed by neck pain in 14 patients (33.33%). The most common sign was limb weakness in 21 patients (50%). 24 patients were operated with foramen magnum decompression with duraplasty and 18 patients were operated without duraplasty. There were more complications in the duraplasty group. Patients showed an overall clinical improvement of 83.33% in the duraplasty group compared to a lower overall clinical improvement rate of 55.50% in the no duraplasty group. Specific symptoms like neck pain showed similar rate of improvement of (88.89%) in the duraplasty group compared to no duraplasty group (80%).Conclusions: Foramen magnum decompression with duraplasty is superior to foramen magnum decompression without duraplasty although slightly higher rate of complication is seen with duraplasty.

Prognostic significance of C1–C2 facet malalignment after surgical decompression in adult Chiari malformation type I: a pilot study based on the Chicago Chiari Outcome Scale

2020 ◽  
pp. 1-7
Author(s):  
Michael Lumintang Loe ◽  
Tito Vivas-Buitrago ◽  
Ricardo A. Domingo ◽  
Johan Heemskerk ◽  
Shashwat Tripathi ◽  
...  
Keyword(s):  
Pilot Study ◽  
Chiari Malformation ◽  
Prognostic Significance ◽  
Foramen Magnum ◽  
Bivariate Analysis ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Swallowing Function ◽  
Chiari Malformation Type I

OBJECTIVEThe authors assessed the prognostic significance of various clinical and radiographic characteristics, including C1–C2 facet malalignment, in terms of surgical outcomes after foramen magnum decompression of adult Chiari malformation type I.METHODSThe electronic medical records of 273 symptomatic patients with Chiari malformation type I who were treated with foramen magnum decompression, C1 laminectomy, and duraplasty at Mayo Clinic were retrospectively reviewed. Preoperative and postoperative Neurological Scoring System scores were compared using the Friedman test. Bivariate analysis was conducted to identify the preoperative variables that correlated with the patient Chicago Chiari Outcome Scale (CCOS) scores. Multiple linear regression analysis was subsequently performed using the variables with p < 0.05 on the bivariate analysis to check for independent associations with the outcome measures. Statistical software SPSS version 25.0 was used for the data analysis. Significance was defined as p < 0.05 for all analyses.RESULTSFifty-two adult patients with preoperative clinical and radiological data and a minimum follow-up of 12 months were included. Motor deficits, syrinx, and C1–C2 facet malalignment were found to have significant negative associations with the CCOS score at the 1- to 3-month follow-up (p < 0.05), while at the 9- to 12-month follow-up only swallowing function and C1–C2 facet malalignment were significantly associated with the CCOS score (p < 0.05). Multivariate analysis showed that syrinx presence and C1–C2 facet malalignment were independently associated with the CCOS score at the 1- to 3-month follow-up. Swallowing function and C1–C2 facet malalignment were found to be independently associated with the CCOS score at the 9- to 12-month follow-up.CONCLUSIONSThe observed results in this pilot study suggest a significant negative correlation between C1–C2 facet malalignment and clinical outcomes evaluated by the CCOS score at 1–3 months and 9–12 months postoperatively. Prospective studies are needed to further validate the prognostic value of C1–C2 facet malalignment and the potential role of atlantoaxial fixation as part of the treatment.

The Association of Chiari Type I Malformation and Neurofibromatosis Type 1

1993 ◽  
Vol 32 (3) ◽  
pp. 189-190 ◽  
Author(s):  
Joseph Dooley ◽  
Daniel Vaughan ◽  
Michael Riding ◽  
Peter Camfield
Keyword(s):  
Neurofibromatosis Type 1 ◽  
Chiari Malformation ◽  
Neurofibromatosis Type ◽  
Foramen Magnum ◽  
Type I ◽  
Chiari Type ◽  
Chiari Type I Malformation ◽  
Chiari Type I ◽  
Chiari Malformations

The association of neurofibromatosis type 1 (NF1) with Chiari malformations of the cerebellum and brain stem has been reported on only two previous occasions.1,2 The pathogenesis of both conditions has remained unclear, although the Chiari type I malformation is most likely due to hypoplasia of the posterior fossa with subsequent extension of the cerebellum through the foramen magnum.3 NF1 is also associated with a variety of cerebral dysplasias.4 We present a patient with both of these dysplastic lesions whose Chiari malformation was asymptomatic.

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