"Conservative" cranio-cervical decompression in the treatment of syringomyelia-Chiari I complex. A prospective study of 20 adult cases

Spine
N Di LorenzoA Fortuna

Abstract

This study was designed to investigate prospectively a series of patients with syringomyelia-Chiari I complex operated on by a minimally invasive procedure. The objective was to determine whether a relatively simple and low-risk osteo-dural decompression would obtain as good clinico-radiological results as those observed after the commonly used, more complex posterior fossa surgery. The majority of hypotheses concerning the pathogenesis of syringomyelia link it to the existence of some derangement of the cerebro-spinal fluid flow at the cranio-spinal level and, consequently, surgical procedures are directed toward decompressing the cranio-cervical junction; however, there is no clear-cut evidence that simple osteo-dural decompression should be associated with manipulation of nervous tissue for the purpose of restoring to normal an altered cerebro-spinal fluid flow dynamic. The procedure consisted of a small suboccipital craniectomy and laminectomy of C1 (when necessary C2 as well), followed by dura mater opening. Exploration and plugging of the obex, resection of arachnoid adherences, or amputation of the amygdala(e) were never performed. Every effort was made to keep the arachnoid intact. The series included 20 patients with p...Continue Reading

Citations

Apr 25, 2012·Neurosurgical Review·Nasser M F El-Ghandour
Jun 16, 2009·Journal of Spinal Disorders & Techniques·Masaya NakamuraKazuhiro Chiba
May 15, 2013·Journal of Neurosurgery·Kenan I ArnautovicFrederick A Boop
May 27, 2006·Neurosurgical Focus·T D AldenT S Park
Dec 1, 2010·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Paolo Perrini, Nicola Di Lorenzo
Mar 19, 2014·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Narihito NagoshiMasaya Nakamura
Sep 1, 2009·Optometry : Journal of the American Optometric Association·Curtis R Baxstrom
Jun 6, 2000·Journal of Neurosurgery·M A Stoodley
Jun 9, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Rachid AssinaJames K Liu
Jul 6, 2017·Journal of Neurosurgical Sciences·Lorenzo GiammatteiFabrice Parker
Jan 1, 2014·Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko·N V Glagolev
Dec 20, 2012·Experimental and Therapeutic Medicine·Changshun BaoLigang Chen

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