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IN CHILDREN WITH SCOLIOSIS AND SYRINGOMYELIA SECONDARY TO CHIARI MALFORMATION, WHAT IS THE ROLE OF FORAMAN MAGNUM DECOMPRESSION? A RETROSPECTIVE REVIEW.



Abstract

Purpose of Study: Literature suggests that decompression of Chiari malformation for syrinx may influence the need for surgical correction of scoliosis: we therefore wished to review the clinical presentation, indications for surgery, complications and requirement for scoliosis correction after foramen magnum decompression in patients with syrinx, secondary to Chiari malformation.

Methods: A retrospective review of the available clinical information including clinic letters, case notes and radiology.

Results: 9 patients were identified. (Age range 4–16) 8 patients had progressive curves.

Neurological symptoms: 2 patients significant, 4 insignificant, 3 none.

Of 9 patients, 1 has not had surgery.

8 patients have had foramen magnum decompressions (+/− laminectomy, +/− duroplasty).

Complications: 1 patient required revision surgery for a radiculopathy > 1year post first operation: this patient required prolonged ventilation for MRSA chest sepsis. 1 patient developed a symptomatic pseudomeningocoele requiring lumbar drainage. All patients had improvement of neurological symptoms.

Of 8 patients having a foramen magnum decompression, 5 required scoliosis correction and 3 did not.

Conclusions: Foramen magnum decompression can relieve neurological symptoms in this cohort of patients.3 of 8 (38%) patients avoided scoliosis correction after decompression and decompression may therefore influence curve progression.

Ethics approval: Not applicable

Interest Statement: None

Correspondence should be addressed to BSS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.