Turkish Neurosurgery 2012 , Vol 22 , Num 3
Cerebellar Tonsillectomy with Suboccipital Decompression and Duraplasty by Small Incision for Chiari I Malformation (with Syringomyelia): Long Term Follow-up of 76 Surgically Treated Cases
Junpeng MA1, Chao YOU1, Haifeng CHEN1, Siqing HUANG1, Chengcheng IEONG2
1West China Hospital, Department of Neurosurgery, P. R. China
2Sichuan University, Westchina Medical School, P. R. China
DOI : 10.5137/1019-5149.JTN.4634-11.1 AIM: To explore the surgical effect of cerebellar tonsillectomy with suboccipital decompression and duraplasty by small surgical incision (3~4cm around the foramina magnum) on treating Chiari I Malformation (CM I) patients.

MATERIAL and METHODS: A retrospective study was undertaken on 76 CM I patients treated by this surgery. The surgical efficacy on clinical symptoms and syringomyelia were overall evaluated and analyzed.

RESULTS: The study included 76 cases (36 men and 40 women; age range, 5–58 years; mean age at surgery, 38.8 years). Preoperative MRI confirmed 56 cases associated with syringomyelia. The follow-up period ranged from 25 to 58 months (median, 46 months). At the end of follow-up, 61 patients (80.26%) had improved, 12 patients (15.79%) were stabilized, and 3 patients (3.95%) had worsened. In MRI scan, syrinx of 55 patients (98.21%) had improved or stabilized compare with syrinx growth in only one patient (1.79%). Statistical analysis reveal the surgical effect tend to be much better in patients with short duration of preoperative symptoms (P=0.001).

CONCLUSION: Cerebellar tonsillectomy with suboccipital decompression and duraplasty can provide long-time cure for most CM I cases. Early diagnosis and surgery is necessary to improve the surgical effect. A 3~4cm incision around foramen magnum is enough for these operations and may be conducive to reduce postoperative complications. Keywords : Chiari malformation, Syringomyelia, Small incision, Surgery, Tonsillectomy, Suboccipital decompression

Corresponding author : Siqing Huang, huangsiqing28@163.com