Surgical Experience in Pediatric Patients with Chiari-I Malformations Aged ≤18 Years.

Objective: The objective of this study was to retrospectively study Chiari I malformation patients (<18 years) treated surgically.

Materials and Methods: Chiari I malformation patients (<18 years) treated surgically at our institute were retrospectively studied.

Results: During the study period between January 1999 and June 2011, fifty patients, aged ≤18 years with Chiari malformation, were treated surgically and formed the basis for this series. There were 21 female children (42%) and 29 male children (58%), with a female-to-male ratio of 1:1. At the last follow-up, oropharyngeal symptoms were improved in 33% ( n = 3/9). Headache/neck/back pain improved in 69.56% of children ( n = 16/23). Upper-extremity pain/weakness/numbness improved in 73.91% of children ( n = 17/23). Ataxia improved in 66.66% of children ( n = 4/6). Lower-limb weakness/hyperreflexia improved in 83.33% of children ( n = 5/6). At follow-up, magnetic resonance imaging for patients with syrinx was available for 75% of patients ( n = 30/50) and not available for 25% of patients ( n = 10/40). Syrinx was diminished in size or resolved in 66.33% of patients ( n = 19/30) and the remaining was same for 36.66% of patients ( n = 11/30).

Conclusions: The main goal of surgery is to arrest the progression of neurological deficits. Foramen magnum decompression with a lax duroplasty is the surgical procedure of choice.