Outcome of Posterior Fossa Decompression and Duroplasty in Adult Chiari Malformation

Abstract

OBJECTIVE: Evaluate of Chiari malformations outcome by the method of decompression with duraplasty.

METHOD: This was a prospective descriptive study, duration: 03-03- 2013 to 3-2019 conducted at neuro spinal & cancer care institute, Karachi, the study included 91 patients of CM I, including criteria after diagnosis with the help of MRI cervical spine, a patient having a headache, neck pain, limbs numbness and syringomyelia. Patients excluded from the study are those previously operated previously, history of cervical trauma, operated for a brain tumour.

RESULTS:  we had 91 CM patients, 58 (63.7%) were male, and 33 (36.26%) were female patients and the means age for this surgical procedure was 32 years old. Moreover, all of the patients were gone through the Posterior Fossa Decompression, C1 Laminectomy and Duraplasty. For duraplasty, we took autologous cervical fascia, 1patient had C1 assimilation. 12 (13.1%) patients had hydrocephalus; Ventriculoperitoneal (VP) shunt was placed. Headache was in 91 patients with duration resolved in 87 (95.6%) patients, neck pain was in 82 (90.1%) patient resolved in 74 (90.2%) cases, syrinx was in 36 (39.5%) cases improved in 28 (77.8%) cases, cerebellar sign improved in 40 (83.3%) out of 48 (52.7%) patient, limb numbness resolved in 56 (71.7%) out of 78 (85.7%) cases swallowing difficulty was 31( 34.0%)cases and improved in 24 (77.4%) cases and weakness in upper limbs was relieved in 31 (34%) patients.