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Sanakoeva A.V.

Burdenko Neurosurgical Institute, Moscow, Russia

Korshunov A.E.

Burdenko Neurosurgical Institute, Moscow, Russia

Kadyrov Sh.U.

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

Khukhlaeva E.A.

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

Kushel' Iu.V.

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

Posterior decompression of the craniovertebral junction in syringomyelia combined with Chiari-1 malformation in children

Authors:

Sanakoeva A.V., Korshunov A.E., Kadyrov Sh.U., Khukhlaeva E.A., Kushel' Iu.V.

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Journal: Burdenko's Journal of Neurosurgery. 2017;81(3): 48‑57

DOI: 10.17116/neiro201781348-56

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POSTERIOR DECOMPRESSION OF THE CRANIOVERTEBRAL JUNCTION IN SYRINGOMYELIA COMBINED WITH CHIARI-1 MALFORMATION IN CHILDREN
POSTERIOR DECOMPRESSION OF THE CRANIOVERTEBRAL JUNCTION IN SYRINGOMYELIA COMBINED WITH CHIARI-1 MALFORMATION IN CHILDREN

To cite this article:

Sanakoeva AV, Korshunov AE, Kadyrov ShU, Khukhlaeva EA, Kushel' IuV. Posterior decompression of the craniovertebral junction in syringomyelia combined with Chiari-1 malformation in children. Burdenko's Journal of Neurosurgery. 2017;81(3):48‑57. (In Russ., In Engl.)
https://doi.org/10.17116/neiro201781348-56

 
Подписка 2025-2 (Burdenko's Journal of Neurosurgery)
 
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Objective — to develop the algorithm for defining the amount of posterior decompression of the craniovertebral junction in children with syringomyelia combined with Chiari-1 malformation. Material and methods. Sixty eight children with syringomyelia and Chiari-1 malformation, under age of 18 years, underwent posterior decompression of the craniovertebral junction (PDCVJ) in the period from January 2001 to June 2016. Seven (10%) patients underwent extradural decompression (EDD), 16 (24%) patients underwent extra-arachnoid duraplasty (EAD), 25 (37%) patients underwent intra-arachnoid dissection (IAD) and duraplasty, and 20 (29%) patients underwent PDCVJ and placement of a fourth ventricle-subarachnoid shunt. Results. Clinical improvement occurred in 85% of patients, and stabilization was observed in 11% of patients. Syringomyelia regressed in 78% of cases. There were no complications associated with EDD; however, re-operation was required in 3 (43%) cases. In the case of EAD, treatment results were satisfactory in 11 (79%) patients; re-operation was required in 2 (12.5%) cases; there were no complications in the early postoperative period. The highest complication rate of 6 (30%) cases was associated with shunt placement and duraplasty. However, long-term results in this group of patients were satisfactory in 16 (94%) cases, and MRI-based positive changes were observed in 100% of cases. Conclusion. According to our analysis, EAD is the method of choice for PDCVJ in children with syringomyelia and Chiari-1 malformation without myelopathy symptoms. In the presence of myelopathy symptoms, intra-arachnoid dissection (with or without shunting) is an acceptable alternative. To our opinion, the use of EDD in syringomyelia is unadvisable.

Keywords:

Keywords Chiari-1 malformation
syringomyelia
decompression

Authors:

Sanakoeva A.V.

Burdenko Neurosurgical Institute, Moscow, Russia

Korshunov A.E.

Burdenko Neurosurgical Institute, Moscow, Russia

Kadyrov Sh.U.

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

Khukhlaeva E.A.

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

Kushel' Iu.V.

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

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