Surgical Management of Chiari Malformation: Analysis of 128 Cases

@article{Guo2007SurgicalMO,
  title={Surgical Management of Chiari Malformation: Analysis of 128 Cases},
  author={Fuyou Guo and Meiyun Wang and Jiang Long and Hua Wang and Hongwei Sun and Bo Yang and Lai-jun Song},
  journal={Pediatric Neurosurgery},
  year={2007},
  volume={43},
  pages={375 - 381}
}
Objective: A variety of surgical interventions have been recommended for patients with Chiari malformations (CMs). In this study, we have evaluated the intraoperative findings and clinical outcome in different-aged patients with CMs undergoing posterior fossa decompression. Methods: Sixteen pediatric and 112 adult cases with CMs underwent suboccipital craniectomy and wide duraplasty as well as autogenous bone grafting in selected cases. The clinical outcome was assessed by evaluation of… 

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References

SHOWING 1-10 OF 35 REFERENCES
Surgical management of syringomyelia–Chiari complex
TLDR
The experience obtained from this study demonstrates that foramen magnum decompression to free the cerebro-spinal fluid pathways combined with a syringosubarachnoid shunt performed at the same operation succeeds in effectively decompressing the syrinx cavity, and follow-up MR images reveal that this collapse is maintained.
Surgical results of posterior fossa decompression for patients with Chiari I malformation
TLDR
Overall, this work favors a tailored posterior fossa craniectomy with dural scoring as the initial surgical procedure in children with Chiari I malformation with or without a syrinx.
Surgical experience in 130 pediatric patients with Chiari I malformations.
TLDR
This is believed to be the largest reported series of pediatric patients who have undergone posterior fossa decompression for Chiari I malformations and almost all syringes will stabilize or improve with posterior fosse decompression and duraplasty.
Chiari type I malformation in children.
Reoperation for Chiari Malformations
TLDR
Factors in this series which were associated with reoperation included a young age at initial surgery, the presence of complex bony anatomy at the foramen magnum, syndromic craniosynostosis, and failure of the surgeon at the initial operation either to assess patency of theForamen of Magendie or correctly place a fourth ventricular stent.
Effects of posterior fossa decompression with and without duraplasty on Chiari malformation-associated hydromyelia.
TLDR
PFD, C1 laminectomy, and duraplasty for the treatment of Chiari I malformation may lead to a more reliable reduction in the volume of concomitant hydromyelia, compared with PFD and C1laminectomy alone.
Treatment of basilar invagination associated with Chiari I malformations in the pediatric population: cervical reduction and posterior occipitocervical fusion.
TLDR
In selected cases, manual cervical distraction and extension, posterior fixation, and fusion appear to provide a safe, effective standalone treatment for basilar invagination associated with Chiari malformation in children.
[Craniovertebral decompression and posterior fossa reconstruction treatment of Chiari syringomyelia complex].
TLDR
Craniovertebral decompression and posterior fossa reconstruction in restoring the cranioverTEbral junction are recommended in the treatment of Chiari malformation/syringomyelia.
...
1
2
3
4
...