[Surgical treatment of syringomyelia associated with Chiari malformation]

There is now a controversy about the methods of surgical treatment in syringomyelia associated with Chiari malformation. In this report, the authors emphasize that syringosubarachnoid shunt is effective as a surgical procedure or syringomyelia associated with Chiari malformation. From 1982 to 1986, 17 patients with syringomyelia associated with Chiari malformation were surgically treated. Seventeen patients underwent 22 operative procedures for syringomyelia. Syringosubarachnoid shunt was used in eighteen patients, foramen magnum decompression with syringosubarachnoid shunt in one, foramen magnum decompression with terminal syringostomy in one, terminal syringostomy in one, and ventriculoperitoneal shunt in one. The average postoperative follow up period was 2 years and 3 months, from 4 months to 4 years and 11 months. Thirteen out of 17 patients showed neurological improvement and 3 patients were neurologically unchanged. In one patient, the symptoms deteriorated. Syringosubarachnoid shunt is an effective therapeutic procedure for the patient with syringomyelia associated with Chiari malformation. We think that shunt malfunction by arachnoiditis after operation could be prevented by inserting the shunt tube into the subarachnoid space and closing the arachnoid membrane.