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Factors contributing improvement of syringomyelia and surgical outcome in type І Chiari malformation

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An Erratum to this article was published on 06 March 2009

An Erratum to this article was published on 06 March 2009

Abstract

Objective

The aim of our study was to compare pre- and postoperative radiologic data of posterior fossa and the improvement of syringomyelia after posterior fossa decompression (PFD) with and without tonsillar management in Chiari type І malformation (CM-I).

Material and methods

A retrospective analysis was made of all patients who underwent PFD between Oct 1991 and March 2007 for CM-I. Fifty-seven patients treated for CM-I at a single institution were included in the study. Patients were divided into two groups according to the procedures used during their PFD: PFD vs. PFD with tonsillar management. To determine whether the tonsillar management or changes of posterior fossa volume relate with surgical outcome, we measure posterior fossa size and syringomyelia pre- and postoperatively using magnetic resonance imaging.

Results

Forty patients (70.2%) received PFD and 17 patients (29.8%) received PFD with tonsillar management. The length of syringomyelia affected improvement of syringomyelia (alteration rate, A-rate). Clinical symptoms, craniectomy size, syringomyelia type, and the surgeon’s specialty did not affect A-rate. Tonsillar management has no significant effect on improvement of syringomyelia. Four patients need repeated surgery due to recurrence.

Conclusion

We have shown that tonsillar management do not lead to improve A-rate, and the radiologic changes of posterior fossa volume do not relate with radiologic improvement of syringomyelia. PFD without tonsillar management is sufficient to improve syringomyelia. The longer syrinx, the more A-rate improve in our study. However, a wider craniectomy is unrelated to A-rate. In cases of recurrent patients, we obtained good results with tonsillar management or syringosubarachnoid shunt.

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Authors and Affiliations

  1. Department of Pediatric Neurosurgery, Brain Research Institute, College of Medicine, Yonsei University, Seoul, South Korea

    Young Seok Park, Dong-Seok Kim & Kyu-Won Shim

  2. Departement of Neurosurgery, Seoul Medical Center, Seoul, South Korea

    Jung-Hee Kim

  3. Departement of Neurosurgery, Bundang CHA Hospital, College of Medicine, Pochon CHA University, Seongnam, South Korea

    Joong-Uhn Choi

  4. Departement of Neurosurgery, Seoul Medical Center, College of Medicine, Yonsei University, 134 Shinchon-dong, Seodaemoon-gu, 120-752, Seoul, South Korea

    Dong-Seok Kim

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  1. Young Seok Park
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Correspondence to Dong-Seok Kim.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s00381-009-0846-2

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Park, Y.S., Kim, DS., Shim, KW. et al. Factors contributing improvement of syringomyelia and surgical outcome in type І Chiari malformation. Childs Nerv Syst 25, 453–459 (2009). https://doi.org/10.1007/s00381-008-0763-9

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