Malformación de Chiari y siringomielia: experiencia 2000-2008 / Chiari malformation and syringomyelia: experience 2000-2008

ABSTRACT

Objetive to describe the postoperative outcome of patients with Chiari malformation (CM) and/or syringomyelia (SM). Methods: the clinical records of patients with CM and SM, treated from 2000 to 2008, were retrospectively reviewed. Data about sex, age, previous history, admission symptoms, magnetic resonance imaging (MRI), treatment modalities, outcome (Odom´s sacale) and postoperative complications were collected. Results: we treated 17 patients (1 male, 16 women); mean age 39 years old (10-66). The admission symptoms were pain in 11 cases, cerebellum/brain stem in 4 cases and spinal cord in 14 cases. Diagnosis was made by MRI CM type I with SM 9 cases, CM I without SM 6 cases, CM type II with SM 1 case and idiopathic SM 1 case. MC II had myelomeningocele and ventricular shunting surgery at 3 months old. In 15 cases we performed a suboccipital craniectomy with duraplasty and C1 posterior arch resection (n12) or C1-C2 posterior arch resection (n3). One case had surgery al another institution and 1 case was not operated because symptoms did not progressed. SM persisted in 4 of the operated cases; in 3 of them a syringopleural shunting (SPS) was performed. In the idiopathic SM a SPS was also performed, but it became obstructed 3 months later. Complications were meningitis 1 case, CSF fistula 1 case and meningitis + CSF fistula 1 case. In CM outcome after 1 year was excellent-good in 13 cases, fair in 1 case and poor in 2 cases. Conclusion: in patients with CM and/or SM, postoperative clinical outcome was excellent-good in 13/16 cases.