Comparison of the surgical results for foramen magnum decompression with and without duraplasty in chiari malformation type 1

Abstract

AIM:The surgical results for foramen magnum decompression (FMD) with and without duraplasty in Chiari Malformation type 1 (CM-1) were compared retrospectively. MATErIAL and METHods:Thirty-nine cases of CM-1 with and without syringomyelia (SM) were included. There were 18 patients in the nonduraplasty and 21 in the duraplasty group. Syringomyelia, tonsillar herniation (TH), preoperative symptom duration, and postoperative SM size were compared. rEsuLTs: No significant difference was found between improvement in the duraplasty group (81%) and the non-duraplasty group (61.1%). In cases whose symptom duration was 0-36 months, improvement in the duraplasty group (93%) was significantly better than in the nonduraplasty group (50%) (p<0.01). The rate of syrinx regression was 92.3% in the duraplasty group and 12.5% in the non-duraplasty group (p<0.05). In cases with SM, the improvement was 21.4% in the non-duraplasty group compared to 78.6% in the duraplasty group (p=0.056). In cases with TH greater than 10 mm, the improvement was 66.7% in the non-duraplasty group, whereas all six cases (100%) in the duraplasty group had improved. CoNCLusIoN:In SM associated cases, cases with TH greater than 10 mm, and whose symptom duration is less than 36 months, duraplasty is a more reliable choice despite a slightly higher rate of complications. BuLGuLAr: Duraplastili (%81) ve duraplastisiz grubun (%61,1) iyileşme oranları arasında anlamlı fark bulunmadı. Preoperatif semptom süresi 0-36 ay arasında olan olgularda; duraplastili grubun iyileşme oranı (%93) duraplastisiz gruba göre (%50) anlamlı oranda yüksekti (p<0.05). Sirenks boyutunda küçülme oranı duraplastili grupta % 92,3 iken duraplastisiz grupta % 12.5 idi (p<0.05). SM bulunan olgularda; duraplastili grubun iyileşme oranı % 78,6, duraplastisiz grubun iyileşme oranı ise % 21,4 idi (p=0.056). TH'un 10 mm'den fazla olduğu olgularda; duraplastisiz grubun iyileşme oranı % 66,7 iken, duraplastili 6 olgunun tamamı iyileşmişti (%100).soNuÇ: SM'li olgularda, TH'un 10 mm'den fazla olduğu olgularda ve semptom süresi 36 aydan kısa olan olgularda duraplasti hafif yüksek komplikasyon oranı olmakla birlikte daha iyi bir seçenek olarak düşünülmüştür.

The addition of duraplasty to posterior fossa decompression in the surgical treatment of pediatric Chiari malformation Type I: a systematic review and meta-analysis of surgical and performance outcomes

“…There were studies in which the population consisted of both pediatric and adult patients. However, to maintain a high degree of applicability for pediatric patients, a number of studies 3,10,24,29,42,52,65 in which clinical outcomes could not be discerned between the children and adult groups were not included. Excluding these studies could have diminished the significance of further outcomes, such as syrinx and scoliosis improvement, and introduced a greater degree of heterogeneity between studies observed in the outcomes of this study, despite the lack of publication bias.…”

Comparison Study between Posterior Fossa Decompression with Duroplasty and Posterior Fossa Decompression without Duroplasty, in 20 Cases of Chiari I Malformation

“…On the other hand Benjamin et al recommended PFD without opening the dura for the vast majority of symptomatic patients with CM-I. He recommended opening the dura in patients with rapidly progressive neurological deficits, rapidly progressive scoliosis with syrinx [15].…”

Breaking Barriers for Cerebrospinal Fluid Flow in Chiari Malformation Type I: “What and How Much Is Enough?” A Retrospective Analysis of 74 Cases

“…Overview of the literature about craniectomy size, C1 arch removal, duraplasty, and tonsillar resection and arachnoid dissection are listed in ►Tables 6 to 9, respectively. 10,[12][13][14][15][16][17][18][19][20]…”