Spinal kyphoscoliosis associated with Chiari formation and syringomyelia- 'recovery' following atlantoaxial fixation: a preliminary report and early results based on experience with 11surgically treated cases.

OBJECTIVE: Immediate postoperative and early clinical outcome of treatment of spinal kyphoscoliosis associated with Chiari formation and syringomyelia and treated by atlantoaxial fixation is described.

MATERIAL AND METHODS: During the period April 2016 to March 2018, 11patients having spinal kyphosciolosis (SKS) as a major presenting symptom in association with Chiari formation and syringomyelia were surgically treated and are analysed retrospectively. There were 6 males and 5 females and their ages ranged from 11 to 17 years (average 14 years). Six patients (54.5 %) had associated neurological symptoms. Nine had neck pain. All patients were treated by atlantoaxial fixation. No manipulation of foramen magnum bone or dura was done. No surgery was done on the subaxial cervical or dorsal spine. Patient satisfaction score (PSS) was based on specially designed questionnaire. Other outcome measures included clinical and radiological assessment data, clinical photographs and video observation, and Scoliosis Research Society Questionnaire.

RESULTS: Apart from improvement in neurological condition more particularly in breathing capability and voice volume restoration, all patients and their relatives noticed recovery in SKS in the immediate postoperative phase. During the average follow-up of 14 months, all patients continued to have progressive symptomatic recovery and recovery from spinal kyphoscoliosis. PSS suggested that all patients were 'highly' satisfied with the surgical outcome.

CONCLUSIONS: Atlantoaxial fixation in patients with Chiari formation and syringomyelia associated with spinal kyphoscoliosis results in reversal of a number of musculoskeletal and neural abnormalities that includes recovery from spinal deformity.