Clinical Symptoms Improve Within 1 Year in Patients With CMI After PFDD

Background: Chiari I malformation (CMI) typically presents with posterior headache and neck pain. The symptoms are exacerbated with straining, coughing, or Valsalva maneuver. Those patients with coexisting syringomyelia also have spinal symptoms. Surgery for these patients is indicated in those with a cough-related headache or syringomyelia-related neurological deficit. Surgery in these patients is posterior fossa and foramen magnum decompression (PFDD). This is often associated with duraplasty. Objective: To evaluate the change in patient symptoms and MRI findings following decompression surgery. Design: Prospective study at a single institution. Participants: 38 symptomatic adult patients with a CMI only or CMI and syringomyelia. Methods: MRI and outpatient visits were performed prior to surgery and then at 3 months postoperatively and 1, 2, 3, 4, and 5 years after surgery. All patients had the same surgical procedure, which consisted of suboccipital craniectomy, C1 laminectomy, du more...