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

Area of Science:

• Neurosurgery
• Pediatric Neurosurgery
• Spinal Surgery

Background:

• Type-1 Chiari malformation involves hindbrain herniation into the spinal canal, often treated with posterior fossa decompression.
• Postoperative complications typically include CSF leaks, infections, or neurological deficits.
• Spinal instability is an infrequently reported complication after this procedure.

Observation:

• A 9-year-old female developed symptomatic torticollis post-craniocervical decompression for Chiari malformation type 1.
• Clinical presentation suggested significant craniocervical instability.
• Radiological evaluation confirmed the diagnosis of instability.

Findings:

• The patient underwent craniocervical stabilization surgery.
• Post-operative follow-up at 12 months demonstrated achieved spinal stability.
• Successful clinical neck alignment was noted after treatment.

Implications:

• This case highlights craniocervical instability as a potential, albeit unusual, complication of Chiari malformation surgery.
• It underscores the importance of recognizing and managing this specific complication.
• Successful surgical stabilization can restore alignment and stability in affected pediatric patients.