[Craniovertebral decompression and posterior fossa reconstruction treatment of Chiari syringomyelia complex].
OBJECTIVE
To study the results of Chiari malformation/syringomyelia (CM-SM) complex treated by craniovertebral decompression and posterior fossa reconstruction (PFR).


METHODS
37 patients of CM-SM complex were treated surgically from 1994 to 1999. All patients underwent craniovertebral decompression and posterior fossa reconstruction. The procedure consisted of suboccipital craniectomy and laminectomy of C1 (when necessary C2), exploration and plugging of the obex, and resection of arachnoid adherence. A wide dural graft was used to reconstruct the cisterna magna artificially. Syrinx shunt was not performed.


RESULTS
Follow-up for 0.5 to 4.5 years showed that 31 patients (83.8%) had their symptoms improved, 5 (13.5%) stabilized, but 1 (2.7%) deteriorated. Magnetic resonance was used to evaluate the morphological results. The shrinkage of the syrinx, upward migration of the hindbrain, the formation of an artificial cisterna magna were observed.


CONCLUSIONS
Craniovertebral decompression and posterior fossa reconstruction in restoring the craniovertebral junction are recommended in the treatment of CM-SM complex.
Xie
J
J
Department of Neurosurgery, Third Clinical School, Bejing Medical University, Beijing 100083, China.
Ma
C
C
Shan
H
H
Song
M
M
Liu
B
B
Chen
X
X
D000293:Adolescent; D000328:Adult; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000601:surgery*; D002648:Child; D003388:Cranial Fossa, Posterior / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013595:Syringomyelia / Q000150:complications / Q000601:surgery*