Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 cases.
We analyze the results of surgical treatment of 60 patients presenting syringomyelia (SM) associated with Chiari malformation (CM) who were operated in the period 1982-2000. For each case, analysis covered 15 signs and 16 symptoms included in a protocol that separated SM signs and symptoms from those of CM. A score system was established in parallel with the protocol to make the evaluation of treatment results easier. All cases were submitted to craniovertebral decompression by C1 and eventually C2 laminectomy and cerebellar tonsillectomy with duramater graft. To evaluate the results, statistical proportion difference tests and variance analyses were made to a reliability index of 95% (p=0.05). We conclude that the statistical improvement of CM signs and symptoms was very significant (p=0). Syringomyelia signs and symptoms also improved significantly, except for "upper limb hyporeflexia", which did not improve. No statistical difference in the improvement of SM symptoms as compared to CM symptom was found. Syringomyelia signs improved statistically more than CM signs. In half of patients, the percent improvement of signs and symptoms ranged between 40% and 60%.
Arruda
José Arnaldo Motta de
JA
Serviço de Neurologia, Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza, CE, Brasil. arnaldo_arruda@uol.com.br
Costa
Carlos Maurício de Castro
CM
Tella
Oswaldo Inácio de
OI
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010985:Platybasia / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D011182:Postoperative Care; D011184:Postoperative Period; D011300:Preoperative Care; D013595:Syringomyelia / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome