TRANSVERSE MICROINCISIONS OF THE OUTER LAYER OF THE DURA-MATER COMBINED WITH FORAMEN MAGNUM DECOMPRESSION AS TREATMENT FOR SYRINGOMYELIA WITH CHIARI-I MALFORMATION

Numerous surgical procedures have been proposed for treatment of syrin gomyelia associated with Chiari I malformation, but the optimal treatm ent has not yet been uniformly standardised. The main aim of the surgi cal treatment of syringomyelia/Chiari I complex is directed toward res toration of physiological cerebrospinal fluid dynamic at the craniover tebral junction. We report the surgical results of eight patients, aff ected by syringomyelia and Chiari I malformation. age range from 18 to 62 years, treated by bony foramen magnum decompression combined with transverse microincisions of the outer layer of the dura mater. In an average postoperative follow-up period of two years neurological sympt oms and signs improved in seven patients. Postoperative magnetic Reson ance showed a decrease in size of the syrinx in seven patients. These results suggest that foramen magnum decompression combined with transv erse microincisions of the outer layer of the dura 1) is an effective and safe treatment option for syringomyelia and Chiari I malformation, 2) corrects the circulatory disturbances of cerebrospinal fluid dynam ic, 3) leads to a decrease in size of the syrinx and to a significant improvement in neurological signs and symptoms, 4) avoids complication s of intradural approaches and syringosubarachnoid shunting.