The curative effect of revision operation for Chiari I malformation complicated with syringomyelia followed surgical treatment

Objective To study the methods and the curative effect of revision operation for Chiari I malformation complicated with syringomyelia followed surgical treatment.Methods The clinical data of 15 patients underwent revision operation for Chiari Ⅰ malformation complicated with syringomyelia followed surgical treatment from May 2004 to April 2013 were retrospectively reviewed,they still had symptoms and signs or/and suffered from symptoms aggravated.In the prior operation there were the enlargement decompression posterior cranial fossa in 8 cases,the decompression with resection of outer layer of the dura in 3 cases,the small bone window craniotomy decompression of posterior cranial fossa and resection of the hernia of cerebella tonsil in 2 cases,the decompression of posterior cranial fossa and dura plastic repair in 2 cases.The resection of the hernia of cerebella tonsil and exploration the fourth ventricle outlet were performed in the revision operation of 15 cases,reconstruction of the fourth ventricle outlet in 3 cases.Results The follow-up study from 4 months to 47 months (average 24.1 months) shown that symptoms were disappeared in 8 cases,significantly improved in 3 cases,improved in 4 cases,and syringomyelia decreased in all cases.Conclusions The resection of the hernia of cerebella tonsil and reconstruction of the fourth ventricle outlet is a safe,reliable and effective treatment for patients with failure surgical management of Chiari Ⅰ malformation complicated with syringomyelia. Key words: Chiari Ⅰ malformation ;  Syringomyelia;  Revision operation