C1 laminectomy for Chiari malformation [Neurosurgery Wiki]

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====== C1 laminectomy for Chiari malformation ======

In 107 patients with [[Chiari type 1 deformity]] from the [[Severance Hospital]], Surgical techniques were divided into four groups based on [[duraplasty]] or [[C1 Laminectomy]] usage. Among the study subjects, 38 patients underwent duraplasty and had their [[syrinx]] volumes measured separately on serial [[magnetic resonance imaging]]. A three-dimensional visualization software was used to evaluate the syrinx-volume decrease rate.

Bony [[decompression]] exhibited a mere 20% volume expansion of the lower half [[posterior fossa]]. C1L offered a 3% additional volume expansion, which rose to 5% when duraplasty was added (p=0.029). There were no significant differences in complication rate when C1L was combined with duraplasty (p=0.526). Syrinx volumes were analyzed in 38 patients who had undergone duraplasty. Among them, 28 patients who had undergone duraplasty without C1L demonstrated a 5.9% monthly decrease in syrinx volume, which was 7.5% in the remaining 10 patients with C1L (p=0.040).

[[C1 Laminectomy]] was effective in increasing [[posterior fossa volume]] expansion, both with and without [[duraplasty]]. A more rapid decrease in [[syrinx volume]] occurred when [[C1 Laminectomy]] was combined with duraplasty
((Hwang JK, Park EK, Shim KW, Kim DS. Effectiveness of [[C1]] [[Laminectomy]] for Chiari Malformation Type 1: Posterior Fossa Volume Expansion and Syrinx-Volume Decrease Rate. Yonsei Med J. 2023 Mar;64(3):191-196. doi: 10.3349/ymj.2022.0506. PMID: 36825345.)).