Resolution of Syringomyelia After Posterior Fossa Decompression with and Without Duraplasty in Chiari Malformation-1
DOI:
https://doi.org/10.36283/PJMD13-3/009Keywords:
Chairi malformation, duraplasty, posterior fossa decompression, spinal cord, syringomyeliaAbstract
Background: Chiari malformations (CMs) encompass a range of clinicopathological conditions that exhibit diverse etiology, pathophysiology, and clinical characteristics. This study was done to compare the resolution of syringomyelia after posterior fossa decompression with and without duraplasty in Chiari malformation-1 (CM-1).
Methods: This Quasi-experimental study was conducted at the Department of Neurosurgery, Mardan Medical Complex, Mardan, from January to November 2023. A non-probability, consecutive sampling technique was adopted. Thirty-two children of either gender, aged below 16 years, presenting with CM-1, and planned to undergo either posterior fossa decompression with duraplasty (PFDD) or posterior fossa decompression without duraplasty (PFD) were analyzed. Duration of procedure (minutes) estimated intra-operative blood loss (ml) and post-surgical complications were noted. Outcomes in terms of resolution or improvement in syringomyelia along with syrinx diameter were compared after 6 months. Qualitative variables were compared using chi-square or Fisher's exact test, and quantitative variables were assessed using independent sample t-tests with p<0.05 considered significant.
Results: Out of 32 children analyzed, 18(56.3%) were boys while the mean age was 11.4±4.2 years. There were 18(56.3%) patients who underwent PFDD while the remaining 14(47.7%) had PFD performed. Syringomyelia resolution (88.9% vs. 92.9%, p=0.7024) were relatively similar. Duration of surgery (2.4±0.7 hours vs. 3.6±1.4 hours, p=0.0035) and hospitalization (29.5±8.5 hours vs. 40.5±9.4, p=0.0018) were significantly less among children who underwent PFD when compared to PFDD.
Conclusion: Foramen magnum decompression with and without duraplasty in Chiari malformation-1 showed similar clinical outcomes and both were effective in reducing the syrinx size associated with syringomyelia.
Keywords: Etiology, Foramen Magnum, Hospitalization, Spinal Cord, Syringomyelia.
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