Skip to main content
SpringerLink
Log in

Posterior Fossa Decompression Combined with Resection of the Cerebellomedullary Fissure Membrane and Expansile Duraplasty: A Radical and Rational Surgical Treatment for Arnold–Chiari Type I Malformation

  • Original Paper
  • Published:
Cell Biochemistry and Biophysics Aims and scope Submit manuscript

Abstract

This study aims to introduce a new surgical procedure for the treatment of Arnold–Chiari type I malformation (ACM-1) and to compare its effectiveness with the techniques described in previous studies. We performed the following procedures: foramen magnum decompression combined with the removal of both the atlanto-occipital membrane, extended resection of the cerebellomedullary fissure arachnoid membrane, and artificial duraplasty to enlarge the membranic posterior fossa without resecting the cerebellar tonsils and syringosubarachnoid shunting. There were 21 ACM-1 patients: 12 cases had osteo-compression on the cerebellar hemisphere, 18 cases had thickened adhered fabric ring that stretched from arachnoid membrane to cerebellar hemisphere, and 15 cases with syringomyelia. The patients were followed up for 6 months to 3 years after the surgery. All patients showed a remarkable recovery of syringomyelia. There were no morbidity or death related to the surgery. Most of ACM-1 patients, the osteo- and membrane compression on cerebellar hemisphere and tonsil were observed during the operation. Therefore, decompression of foramen magnum and posterior craniocervical combined with the removal of cerebellomedullary fissure arachnoid membrane and placement of an artificial dural graft should be considered as a comprehensive option of minimally invasive surgery and rational and radical treatment of ACM-1. Our experience showed that, by using our procedure, shunting becomes no longer necessary in the treatment of ACM-1-associated syringomyelia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Tator, C. H., Meguro, K., & Rowed, D. W. (1982). Favorable results with syringosubarachnoid shunts for treatment of syringomyelia. Journal of Neurosurgery, 56, 517–523.

    Article  CAS  PubMed  Google Scholar 

  2. Krieger, M. D., McComb, J. G., & Levy, M. L. (1999). Toward a simpler surgical management of Chiari I malformation in a pediatric population. Pediatric Neurosurgery, 30, 113–121.

    Article  CAS  PubMed  Google Scholar 

  3. Goel, A., & Desai, K. (2000). Surgery for syringomyelia: An analysis based on 163 surgical cases. Acta Neurochirurgica, 142, 293–301.

    Article  CAS  PubMed  Google Scholar 

  4. Chou, Y. C., Sarkar, R., Osuagwu, F. C., & Lazareff, J. A. (2009). Suboccipital craniotomy in the surgical treatment of Chiari I malformation. Childs Nervous System, 25, 1111–1114.

    Article  Google Scholar 

  5. Huang, P. P., & Constantini, S. (1994). “Acquired” Chiari I malformation. Case report. Journal of Neurosurgery, 80, 1099–1102.

    Article  CAS  PubMed  Google Scholar 

  6. Duddy, M. J., & Williams, B. (1991). Hindbrain migration after decompression for hindbrain hernia: a quantitative assessment using MRI. British Journal of Neurosurgery, 5, 141–152.

    Article  CAS  PubMed  Google Scholar 

  7. Saceda-Gutierrez, J. M., Isla-Guerrero, A., Alvarez-Ruiz, F., Odene-Cantero, C., Hernandez-Garcia, B., & Marquez Perez, T. M. (2011). [Postoperative complications in Chiari I malformation: Duroplasty and cerebrospinal fluid leak]. Neurocirugia (Astur)., 22, 36–42.

    CAS  PubMed  Google Scholar 

  8. Todo, T., Usui, M., & Araki, F. (1993). Dandy-Walker syndrome forming a giant occipital meningocele—case report. Neurologia Medico-Chirurgica (Tokyo), 33, 845–850.

    Article  CAS  Google Scholar 

  9. Batzdorf, U. (1988). Chiari I malformation with syringomyelia. Evaluation of surgical therapy by magnetic resonance imaging. Journal of Neurosurgery, 68, 726–730.

    Article  CAS  PubMed  Google Scholar 

  10. Hida, K., Iwasaki, Y., Koyanagi, I., Sawamura, Y., & Abe, H. (1995). Surgical indication and results of foramen magnum decompression versus syringosubarachnoid shunting for syringomyelia associated with Chiari I malformation. Neurosurgery, 37, 673–678.

    Article  CAS  PubMed  Google Scholar 

  11. Sindou, M., & Gimbert, E. (2009). Decompression for Chiari type I-malformation (with or without syringomyelia) by extreme lateral foramen magnum opening and expansile duraplasty with arachnoid preservation: comparison with other technical modalities (Literature review). Advances and Technical Standards in Neurosurgery, 34, 85–110.

    CAS  PubMed  Google Scholar 

  12. Takigami, I., Miyamoto, K., Kodama, H., Hosoe, H., Tanimoto, S., & Shimizu, K. (2005). Foramen magnum decompression for the treatment of Arnold Chiari malformation type I with associated syringomyelia in an elderly patient. Spinal Cord, 43, 249–251.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, The Affiliated Futain Hospital of Guangdong Medical College, The Fourth Hospital of Shenzhen, Shenzhen, P.O. 0086 518033, Guangdong, People’s Republic of China

    Chen Jian Liang, Qiu Jian Dong, You Heng Xing, Ma Shan, Lian Xiao Wen, Zhong Yuan Qiang, Zhang Qing Ping, Peng Zhi Tao & Huang Xiao Ping

  2. Neurosurgical Department, Traditional Chinese Medical hospital of Shenzhen, Shenzhen, P.O. 0086 518033, Guangdong, People’s Republic of China

    Huang Xiao Ping

Authors
  1. Chen Jian Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Qiu Jian Dong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. You Heng Xing
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ma Shan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lian Xiao Wen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zhong Yuan Qiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Zhang Qing Ping
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Peng Zhi Tao
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Huang Xiao Ping
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Chen Jian Liang or Huang Xiao Ping.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liang, C.J., Dong, Q.J., Xing, Y.H. et al. Posterior Fossa Decompression Combined with Resection of the Cerebellomedullary Fissure Membrane and Expansile Duraplasty: A Radical and Rational Surgical Treatment for Arnold–Chiari Type I Malformation. Cell Biochem Biophys 70, 1817–1821 (2014). https://doi.org/10.1007/s12013-014-0135-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12013-014-0135-x

Keywords

Search

Navigation