ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2026
Extradural foramen magnum decompression with multiple superficial dural incisions for Chiari I malformation: a multicenter series of 91 pediatric patients.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo assess surgical outcome of pediatric patients undergoing foramen magnum decompression (FMD) with multiple superficial dural incisions (MSDI) in Chiari I malformation (CM I), with or without syringomyelia.
methodsA retrospective review of 91 pediatric patients who underwent FMD with MSDI technique between 2010 and 2024 at three tertiary neurosurgical centers.
resultsMedian age at surgery was 10 years (range 1-18). 57% were female. Preoperative symptoms included headaches/neck pain (55%), neurological deficits (44%), dysphagia (13%), snoring (18%), and cranial nerve involvement (12%). Syringomyelia was present in 48 patients (53%). All patients underwent C1 laminectomy in addition to FMD, and 10% also C2 laminectomy. Short term complications occurred in 7 cases (8%). All were wound problems which did not require reoperation. Median follow-up time was 3 years (range 1-13). Postoperatively: Headaches improved in 90% (45/50) Syrinx size reduced or was stable in 87% (42/48) Syrinx size progression was seen in 13% (6/48) Four patients (4%) developed a new syrinx following the procedure Neurological deficits improved or stabilized in 87% (34/40) No surgical site infection, CSF leak, hydrocephalus, or new permanent neurological deficits were observed. The reoperation rate was 10%.
conclusionOur results indicate that extradural FMD with MSDI can be considered a safe and effective treatment of CM I in pediatric patients, even in the presence of syringomyelia. No correlations between age, gender, scoliosis, tonsil herniation level, follow-up length, syrinx size and level, CXA, pB-C2, surgeon, and syrinx changes after surgery were found. Age showed no significant correlation with postoperative headache improvement.
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