Posterior fossa decompression with and without duraplasty in adults with Chiari malformation type I: comparative study | ||||
| Pan Arab Journal of Neurosurgery | ||||
| Article 3, Volume 19, Issue 2, December 2024, Page 93-100 PDF (951.21 K) | ||||
| Document Type: Original Articles | ||||
| DOI: 10.21608/pajn.2024.273995.1120 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Hany M Elkholy  1; Osama Elsherif2
| ||||
| 1Shibin el kom, Menofia, Egypt | ||||
| 2faculty of Medicine, Menoufia University | ||||
| Abstract | ||||
| Background: The widely accepted management for patients with symptomatic Chiari malformation type 1 (CM-I) is the decompression of posterior fossa. Adding duraplasty still has no general consensus. Aim: To identify the impact of duraplasty on clinical outcomes in adult CM-I patients. Patients and Methods: Retrospectively, 18 adult CM-I patients with syringomyelia were included. Patients underwent decompression of the posterior fossa either with duraplasty (decompression plus duraplasty group) or without duraplasty (only decompression group). The impact of duraplasty on short term (after one and three months) and on long-term (after 12 months) clinical outcomes was compared between the 2 groups. Results: 11 patients (61.1%) were operated by decompression plus duraplasty and 7 patients (38.9%) underwent only decompression. Hospital stay was significantly longer in decompression plus duraplasty group (P = 0.037). CSF leak was the only postoperative complication with significant difference (P = 0.038). A statistically significant high rate of complications was observed in cases with synthetic dural graft. Postoperative syrinx regression was statistically significant in decompression plus duraplasty group (P = 0.024). Short-term outcome results were non-significant between the two groups, however, clinical outcome after 12 months of follow up was significantly better in decompression plus duraplasty group (P = 0.025). Conclusions: Despite having a longer average hospital stay and a slightly higher rate of complications, decompression plus duraplasty can be associated with significant syrinx regression and a better long-term clinical outcome than decompression alone. Autologous fascia lata graft seemed to be more reliable for duraplasty with fewer complications. | ||||
| Keywords | ||||
| Chiari Malformation; Decompression plus Duraplasty; Syringomyelia | ||||
|
Statistics Article View: 168 PDF Download: 120 |
||||
