Surgical Treatment of Chiari Malformation in Adults: Comparison of Surgical Techniques Described in the Literature and Our Experience

  • L. Lavorato
  • A. Spallone
  • M. Visocchi
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 125)


This paper has been edited for clarity, correctness and consistency with our house style. Please check it carefully to make sure the intended meaning has been preserved. If the intended meaning has been inadvertently altered by the editing changes, please make any corrections needed.


Chiari Malformation Surgery Techniques 


  1. 1.
    Abd-El-Barr MM, Strong CI, Groff MW. Chiari malformations: diagnosis, treatments and failures. J Neurosurg Sci. 2014;58:215–21.PubMedGoogle Scholar
  2. 2.
    Greenberg MS. Handbook of neurosurgery. 7th ed. New York: Thieme; 2010.Google Scholar
  3. 3.
    Speer MC, Enterline DS, Mehltretter L, et al. Chiari type I malformation with or without syringomyelia: prevalence and genetics. J Genet Couns. 2003;12:297–311.CrossRefGoogle Scholar
  4. 4.
    Batzdorf U. Syringomyelia, Chiari malformation and hydromyelia. In: Youman JR, editor. Neurological surgery. 4th ed. Philadelphia: Saunders; 1996. p. 1090–109.Google Scholar
  5. 5.
    Tubb RS, Pugh JA, Oakes WJ. Chiari malformations. In: Winn HR, editor. Youmans neurological surgery. 6th ed. Philadelphia: Elsevier Saunders; 2011. p. 1918–27.CrossRefGoogle Scholar
  6. 6.
    Batzdorf U. Microsurgery of syringomyelia and syringomyelia cord syndrome. In: Schmidek HH, Roberts DW, editors. Operative neurosurgical techniques. 5th ed. Philadelphia: Saunders Elsevier; 2006. p. 1767–75.Google Scholar
  7. 7.
    Pollack IF, Pang D, Albright AL, et al. Outcome following hindbrain decompression of symptomatic Chiari malformations in children previously treated with myelomeningocele closure and shunt. J Neurosurg. 1992;77:881–8.CrossRefGoogle Scholar
  8. 8.
    Castillo M. Neuroradiology companion. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2012.Google Scholar
  9. 9.
    Badie B, Mendoza D, Batzdorf U. Posterior fossa volume and response to suboccipital decompression in patients with Chiari I malformation. Neurosurgery. 1995;37:214–8.CrossRefGoogle Scholar
  10. 10.
    Alzate JC, Kothbauer KF, Jallo GI, Epstein FJ. Treatment of Chiari I malformation in patients with and without syringomyelia: a consecutive series of 66 cases. Neurosurg Focus. 2001;11:E3.PubMedGoogle Scholar
  11. 11.
    Cahan LD, Bentson JR. Considerations in the diagnosis and treatment of syringomyelia and the Chiari malformation. J Neurosurg. 1982;57:24–31.CrossRefGoogle Scholar
  12. 12.
    Rhoton AL Jr. Microsurgery of Arnold–Chiari malformation in adults with and without hydromyelia. J Neurosurg. 1976;45:473–83.CrossRefGoogle Scholar
  13. 13.
    Williams B. Surgery for hindbrain related syringomyelia. Adv Tech Stand Neurosurg. 1993;20:107–64.CrossRefGoogle Scholar
  14. 14.
    Tubbs RS, McGirt MJ, Oakes WJ. Surgical experience in 130 pediatric patients with Chiari I malformations. J Neurosurg. 2003;99:291–6.CrossRefGoogle Scholar
  15. 15.
    Findlay G, Owen R. Surgery of the spine: a combined orthopaedic and neurosurgical approach. Boston: Blackwell Scientific Publications; 1992.Google Scholar
  16. 16.
    Yeh DD, Koch B, Crone KR. Intraoperative ultrasonography used to determine the extent of surgery necessary during posterior fossa decompression in children with Chiari malformation type I. J Neurosurg. 2006;105(1 Suppl):26–32.PubMedGoogle Scholar
  17. 17.
    McGirt MJ, Nimjee SM, Fuchs HE, George TM. Relationship of cine phase-contrast magnetic resonance imaging with outcome after decompression for Chiari I malformations. Neurosurgery. 2006;59:140–6. discussion 140–6.CrossRefGoogle Scholar
  18. 18.
    Genitori L, Peretta P, Nurisso C, Macinante L, Mussa F. Chiari type I anomalies in children and adolescents: minimally invasive management in a series of 53 cases. Childs Nerv Syst. 2000;16(10–11):707–18.CrossRefGoogle Scholar
  19. 19.
    Klekamp J, Batzdorf U, Samii M, Bothe HW. The surgical treatment of Chiari I malformation. Acta Neurochir. 1996;138:788–801.CrossRefGoogle Scholar
  20. 20.
    Munshi I, Frim D, Stine-Reyes R, et al. Effects of posterior fossa decompression with and without duraplasty on Chiari malformation–associated hydromyelia. Neurosurgery. 2000;46:1384–9. discussion 1389–90.CrossRefGoogle Scholar
  21. 21.
    Guyotat J, Bret P, Jouanneau E, Ricci AC, Lapras C. Syringomyelia associated with type I Chiari malformation. A 21-year retrospective study on 75 cases treated by foramen magnum decompression with a special emphasis on the value of tonsils resection. Acta Neurochir. 1998;140(8):745–54.CrossRefGoogle Scholar
  22. 22.
    Limonadi FM, Selden NR. Dura-splitting decompression of the craniocervical junction: reduced operative time, hospital stay, and cost with equivalent early outcome. J Neurosurg. 2004;101(2 Suppl):184–8.PubMedGoogle Scholar
  23. 23.
    Cai C, Oakes WJ. Hindbrain herniation syndromes: the Chiari malformations (I and II). Semin Pediatr Neurol. 1997;4(3):179–91.CrossRefGoogle Scholar
  24. 24.
    Park JK, Gleason PL, Madsen JR, Goumnerova LC, Scott RM. Presentation and management of Chiari I malformation in children. Pediatr Neurosurg. 1997;26(4):190–6.CrossRefGoogle Scholar
  25. 25.
    Ergun R, Akdemir G, Gezici AR, et al. Surgical management of syringomyelia–Chiari complex. Eur Spine J. 2000;9(6):553–7.CrossRefGoogle Scholar
  26. 26.
    Goel A, Desai K. Surgery for syringomyelia: an analysis based on 163 surgical cases. Acta Neurochir. 2000;142:293–301. discussion 301–2.CrossRefGoogle Scholar
  27. 27.
    Brockmeyer D, Gollogly S, Smith JT. Scoliosis associated with Chiari 1 malformations: the effect of suboccipital decompression on scoliosis curve progression: a preliminary study. Spine. 2003;28:2505–9.CrossRefGoogle Scholar
  28. 28.
    Sengupta DK, Dorgan J, Findlay GF. Can hindbrain decompression for syringomyelia lead to regression of scoliosis? Eur Spine J. 2000;9(3):198–201.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • L. Lavorato
    • 1
  • A. Spallone
    • 1
    • 2
  • M. Visocchi
    • 3
  1. 1.NCL—NEUROMED, Institute of NeuroscienceRomeItaly
  2. 2.Catholic University “Our Lady of Good Counsel”TiranaAlbania
  3. 3.Department of NeurosurgeryPoliclinico “A. Gemelli”, University “Cattolica”RomeItaly

Personalised recommendations