Management of foramen magnum stenosis in patients with achondroplasia: relative merit of clinical and radiological indications for foramen magnum decompression

2019 ◽  
Author(s):  
Timoteo Almeida ◽  
William Singleton ◽  
Fergal Monsell ◽  
Sarah Smithson ◽  
Richard Edwards ◽  
...  
Keyword(s):  
Foramen Magnum ◽  
Relative Merit ◽  
Foramen Magnum Decompression

Prognostic significance of C1–C2 facet malalignment after surgical decompression in adult Chiari malformation type I: a pilot study based on the Chicago Chiari Outcome Scale

2020 ◽  
pp. 1-7
Author(s):  
Michael Lumintang Loe ◽  
Tito Vivas-Buitrago ◽  
Ricardo A. Domingo ◽  
Johan Heemskerk ◽  
Shashwat Tripathi ◽  
...  
Keyword(s):  
Pilot Study ◽  
Chiari Malformation ◽  
Prognostic Significance ◽  
Foramen Magnum ◽  
Bivariate Analysis ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Swallowing Function ◽  
Chiari Malformation Type I

OBJECTIVEThe authors assessed the prognostic significance of various clinical and radiographic characteristics, including C1–C2 facet malalignment, in terms of surgical outcomes after foramen magnum decompression of adult Chiari malformation type I.METHODSThe electronic medical records of 273 symptomatic patients with Chiari malformation type I who were treated with foramen magnum decompression, C1 laminectomy, and duraplasty at Mayo Clinic were retrospectively reviewed. Preoperative and postoperative Neurological Scoring System scores were compared using the Friedman test. Bivariate analysis was conducted to identify the preoperative variables that correlated with the patient Chicago Chiari Outcome Scale (CCOS) scores. Multiple linear regression analysis was subsequently performed using the variables with p < 0.05 on the bivariate analysis to check for independent associations with the outcome measures. Statistical software SPSS version 25.0 was used for the data analysis. Significance was defined as p < 0.05 for all analyses.RESULTSFifty-two adult patients with preoperative clinical and radiological data and a minimum follow-up of 12 months were included. Motor deficits, syrinx, and C1–C2 facet malalignment were found to have significant negative associations with the CCOS score at the 1- to 3-month follow-up (p < 0.05), while at the 9- to 12-month follow-up only swallowing function and C1–C2 facet malalignment were significantly associated with the CCOS score (p < 0.05). Multivariate analysis showed that syrinx presence and C1–C2 facet malalignment were independently associated with the CCOS score at the 1- to 3-month follow-up. Swallowing function and C1–C2 facet malalignment were found to be independently associated with the CCOS score at the 9- to 12-month follow-up.CONCLUSIONSThe observed results in this pilot study suggest a significant negative correlation between C1–C2 facet malalignment and clinical outcomes evaluated by the CCOS score at 1–3 months and 9–12 months postoperatively. Prospective studies are needed to further validate the prognostic value of C1–C2 facet malalignment and the potential role of atlantoaxial fixation as part of the treatment.

Hydrosyringomyelia Associated with a Chiari I Malformation in Children and Adolescents

Neurosurgery ◽  
1990 ◽  
Vol 26 (4) ◽  
pp. 591-597 ◽  
Author(s):  
Toyohiko Isu ◽  
Yoshinohu Iwasaki ◽  
Minoru Akino ◽  
Hiroshi Abe
Keyword(s):  
Surgical Treatment ◽  
Children And Adolescents ◽  
Foramen Magnum ◽  
Chiari I Malformation ◽  
Motor Deficits ◽  
Foramen Magnum Decompression ◽  
Axial Section ◽  
Lower Cranial Nerve ◽  
Thoracic Level ◽  
Initial Symptoms

Abstract The clinical presentation, radiological features, and results of surgical treatment were analyzed in 17 cases of hydrosyringomyelia associated with a Chiari malformation, in children and adolescents younger than 20 years of age. The initial symptoms were a skeletal abnormality (71%), such as scoliosis (11 patients) or pes cavus (1 patient), pain or numbness (24%), and motor weakness (6%). Frequently seen signs on admission were sensory deficit (100%), scoliosis (85%), muscle weakness (64%), muscle atrophy (35%), and lower cranial nerve palsy (35%), The characteristic neurological findings were unilateral sensory and motor deficits (65%) with decreased or absent deep tendon reflexes on the same side. The localization of the syrinx on the axial section varied according to the level, even in the same patient. In 11 patients with unilateral sensory disturbances or unilateral sensory and motor deficits, the syrinx was located in the region corresponding to the posterolateral portion on the same side as that of sensory disturbance at the cervical or thoracic level. On the other hand, in 6 patients with bilateral sensory and motor deficits, the syrinx was located in the central portion and extended into the posterolateral portion of the more affected side. A syringosubarachnoid shunt was placed in 16 patients, foramen magnum decompression without closure of the obex was performed in 1 patient, ventriculoperitoneal shunt in 1 patient, terminal syringostomy in 1 patient, and foramen magnum decompression with terminal syringostomy in 1 patient. In 15 of 17 patients (88%), the neurological symptoms improved after an average follow-up of 4 years and 1 month. We think that as a surgical treatment, placement of a syringosubarachnoid shunt is effective.

scholarly journals Re-evaluation of foramen magnum decompression with dura left open for Chiari I malformation

2017 ◽  
Vol 10 ◽  
pp. 150-154 ◽  
Author(s):  
Tetsuryu Mitsuyama ◽  
Yasuo Aihara ◽  
Takaomi Taira ◽  
Seiichiro Eguchi ◽  
Kentaro Chiba ◽  
...  
Keyword(s):  
Foramen Magnum ◽  
Chiari I Malformation ◽  
Foramen Magnum Decompression ◽  
Chiari I

scholarly journals A Case of Chiari Malformation Type I : Improvement of Syringomyelia and Scoliosis by Foramen Magnum Decompression Alone

1999 ◽  
Vol 8 (11) ◽  
pp. 727-731
Author(s):  
Tetsuya Kubota ◽  
Kenichi Nishiyama ◽  
Akira Tamura ◽  
Kouichi Kawasaki ◽  
Hiroshi Masuda ◽  
...  
Keyword(s):  
Chiari Malformation ◽  
Foramen Magnum ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Chiari Malformation Type I

Posterior Calvarial Augmentation for Chiari Malformation Type 1 Refractory to Foramen Magnum Decompression

2020 ◽  
Vol 139 ◽  
pp. 70-74 ◽  
Author(s):  
Fardad T. Afshari ◽  
Guirish A. Solanki ◽  
William B. Lo ◽  
Desiderio Rodrigues
Keyword(s):  
Chiari Malformation ◽  
Foramen Magnum ◽  
Foramen Magnum Decompression ◽  
Chiari Malformation Type 1
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