The symposium is co-organised by The Ann Conroy Trust, in association with Aesculap Academia.
The Ann Conroy Trust is Registered Charity No: 1165808.
We provide Support, Education and Research for patients living with Chiari Malformation, Syringomyelia and associated conditions.
F5 Surgical treatment of syringomyelia associated with Chiari malformation type 1. Analysis of surgical treatment of 124 patients.
Zuev A, Pedyash N, Epifanov D, Lebedev V, Ghodiwala T.
The purpose of the study was to analyse the results of treatment of patients with syringomyelia associated with Chiari malformation type 1.
During the period from 2013 to 2017 we treated 221 patients with syringomyelia associated with Chiari malformation type 1. Of these, 124 patients were treated surgically, all operations being performed by one surgeon. All patients underwent clinical investigation before surgery and thorough observation was carried out post-operation. All patients underwent MRI investigation in the early postoperative period, to assess the adequacy of decompression. Further, clinical and MRI examinations were carried out at 4 months and 1 year after surgery, for most patients, and annually thereafter.
Results. At 4 months after surgery the syringomyelia cavity disappeared in 19 patients (15%), decreased in 89 (72%) and remained unchanged in 16 patients (13%). At 1 year after the operation, the clinical condition had either improved or remained unchanged in 120 patients (97%). In 4 patients (3%) the syringomyelia continued to progress clinically. Cine-MRI in these cases showed no disturbance of CSF flow at the craniocervical junction and these patients therefore underwent syringo-subarachnoid shunting, resulting in a good clinical outcome. During follow-up we had no relapse of CSF flow obstruction at the craniocervical junction. Early postoperative complications occurred in 4 patients (3%): 1 CSF leak, 1 acute epidural hematoma, and 2 cases of aseptic meningitis. In 11 patients the headache increased initially after surgery but improved after about one month.
Sub-occipital craniotomy, followed by duraplasty and restoration of CSF flow at the craniocervical junction, is an effective method of treatment for patients with syringomyelia associated with Chiari malformation type 1