Effect of Posterior Fossa Decompression for Chiari Malformation-I on Scoliosis

Pediatr Neurosurg. 2018;53(2):108-115. doi: 10.1159/000485254. Epub 2018 Jan 4.

Abstract

Background/aims: Scoliosis is common in patients with Chiari malformation-I (CM-I). This study examined the change in scoliosis severity after posterior fossa decompression (PFD) for CM-I.

Methods: We conducted a retrospective review at a single tertiary center for children undergoing PFD with untreated scoliosis, and identified 17 patients with complete follow-up data and imaging.

Results: Overall, scoliosis improved in 7 (41.2%) patients, worsened in 9 (52.9%), and remained unchanged in 1 (5.9%) after PFD (mean follow-up of 7.8 ± 4.1 months). We found that 3 of the 8 (38%) children with early-onset scoliosis eventually needed scoliosis corrective surgery, which was needed in 7 of the 9 (78%) patients with adolescent-onset scoliosis. In addition, only 1 patient (17%) with a preoperative scoliosis curve <35 degrees and 9 patients (82%) with a curve ≥35 degrees required surgery for scoliosis correction despite PFD (p = 0.018).

Conclusion: In certain patients, PFD for CM-I may lead to improvement or stabilization of scoliosis.

Keywords: Adolescent onset; Chiari malformation-I; Early onset; Posterior fossa decompression; Scoliosis.

MeSH terms

  • Adolescent
  • Arnold-Chiari Malformation / complications
  • Arnold-Chiari Malformation / surgery*
  • Child
  • Cranial Fossa, Posterior / surgery*
  • Decompression, Surgical / methods*
  • Female
  • Humans
  • Male
  • Neurosurgical Procedures
  • Retrospective Studies
  • Scoliosis*