Craniocervical spinal instability after type 1 Arnold Chiari decompression: a case report

J Pediatr Orthop B. 2017 Jan;26(1):80-85. doi: 10.1097/BPB.0000000000000346.


To present and describe an unusual case of spinal instability after craniocervical spinal decompression for a type-1 Chiari malformation. Type-1 Chiari malformation is a craniocervical disorder characterized by tonsillar displacement greater than 5 mm into the vertebral canal; posterior fossa decompression is the most common surgical treatment for this condition. Postoperative complications have been described: cerebrospinal fluid leak, pseudomeningocele, aseptic meningitis, wound infection, and neurological deficit. However, instability after decompression is unusual. A 9-year-old female presented with symptomatic torticollis after cervical decompression for a type-1 Chiari malformation. Spinal instability was diagnosed; craniocervical stabilization was performed. After a 12-month follow-up, spinal stability was achieved, with a satisfactory clinical neck alignment. We present a craniocervical instability secondary to surgical decompression; clinical and radiological symptoms, and definitive treatment were described.

Publication types

  • Case Reports

MeSH terms

  • Arnold-Chiari Malformation / surgery*
  • Child
  • Decompression, Surgical*
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Instability / surgery
  • Magnetic Resonance Imaging
  • Neurosurgical Procedures*
  • Orthopedics / methods
  • Postoperative Complications / diagnosis
  • Radiography
  • Reoperation
  • Syringomyelia / etiology*