Letter: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Patients With Chiari Malformation: Surgical Interventions

In Reply: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Patients With Chiari Malformation: Surgical Interventions

“…We thank Dr Goel for his very thoughtful comments. 1 He discussed in his letter to the editor his hypothesis that Chiari I Malformation (CIM) is caused by cranial cervical instability, and he cited his published experience treating CIM with cranial cervical fusion. He calls his idea “novel and probably revolutionary,” and he states that “any kind of bone decompression in an already unstable spinal segment can form a negative form of surgical treatment.” He also states that “it is relevant to state that his article was the first to state that opening of the dura is unnecessary during foramen magnum decompression for Chiari malformation with or without associated syringomyelia.” Dr Goel expressed that he wished we had acknowledged his contribution to Chiari malformation.…”