| Abstrakt: |
Objective: To evaluate outcome of posterior fossa decompression and duroplasty in patients with Chiari Malformation 1 (CM1). Methods: This retrospective study was conducted at Neurospinal and Cancer Care Institute, Karachi, from March 2010 to March 2019. After diagnosis with the help of Magnetic Resonance Imaging (MRI) cervical spine, all patients with CM I, having headache, neck pain, limbs numbness and syringomyelia were included. Information was collected regarding demographic characteristics, presenting complaints, and post-operative outcome. Chicago Chiari outcome scale was used to assess the outcome. Results: Of 91 patients, the mean age of the patient was 31 ±6.7 years. There were 58 (63.7%) males and 33 (36.3%) females. C2 laminectomy was performed in 10 (11.0%) patients while C1 assimilation in 3 (3.3%) patients. Hydrocephalus was found in 12 (13.1%) patients. The outcome of posterior fossa decompression (PFD) showed that functional outcome was found higher, i.e., 46 (50.5%), followed by excellent outcome 25 (27.5%), impaired outcome 15 (16.5%), and incapacitated in 5 (5.5%). The comparison of outcome with baseline characteristics showed that most of the patients with age >30 years had excellent and functional outcome, i.e., 16 (28.1%) and 26 (45.6%) respectively. Five (8.6%) females had incapacitated outcome. Moreover, headache, syringomyelia, and swallowing difficulty were observed somewhat equal in each outcome. Conclusions: PFD surgery with duraplasty can improve the clinical symptoms. Decompressive surgery in patients with duraplasty can significantly improve the patient condition while late presentation may affect the clinical outcome. [ABSTRACT FROM AUTHOR] |
