Posterior decompression of the craniovertebral junction in children with Chiari malformation: a surgery extent issue

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Korshunov A.E.

Burdenko Neurosurgical Institute, Moscow, Russia

Kushel' Iu.V.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Posterior decompression of the craniovertebral junction in children with Chiari malformation: a surgery extent issue

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Korshunov A.E., Kushel' Iu.V.

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Journal: Burdenko's Journal of Neurosurgery. 2016;80(4): 13‑20

DOI: 10.17116/neiro201680413-20

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To cite this article:

Korshunov AE, Kushel' IuV. Posterior decompression of the craniovertebral junction in children with Chiari malformation: a surgery extent issue. Burdenko's Journal of Neurosurgery. 2016;80(4):13‑20. (In Russ., In Engl.)
https://doi.org/10.17116/neiro201680413-20

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)

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Abstract:

Objective. The study objective was to develop a rational approach for defining the extent of posterior decompression in children with Chiari 1 malformation. Material and methods. Posterior decompression was performed in 76 children with Chiari 1 malformation, under 18 years of age, in the period between 2001 and 2015. Fifty two (68%) children had syringomyelia. Extradural decompression (EDD) was performed in 14 (18%) cases, extra-arachnoid duraplasty (EAD) in 21 (28%) cases, intra-arachnoid dissection and duraplasty in 21 (28%) cases, and foramen of Magendie stenting and duraplasty in 20 (26%) cases. Results. Complications occurred in 15 (20%) patients, with one of them being fatal (case fatality rate, 1.3%). The complication rate was higher after (1) intra-arachnoid dissection (p=0.0009) and stenting (p=0.02). Re-operation was required in 8 (11%) patients. The overall rate of complications and re-operations was lowest after EAD (10%). Conclusion. EAD is the method of choice for Chiari 1 malformation in children. EDD can be adopted as a primary option, but it requires selection of relevant patients. Intra-arachnoid dissection, with/without stenting, is not advisable as a primary intervention, but may be inevitable in the re-operation case.

Keywords:

Chiari 1 malformation

syringomyelia

posterior decompression

Authors:

Korshunov A.E.

Burdenko Neurosurgical Institute, Moscow, Russia

Kushel' Iu.V.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

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References:

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