Full-Endoscopic Technique for Posterior Fossa Decompression in Chiari Malformation

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Endoscopic Techniques

Background:

• Full-endoscopic techniques are established for spinal surgery.
• Endoscopic-assisted posterior fossa decompression (PFD) for Chiari malformation (CM) has been described, but a fully endoscopic approach is novel.
• This study addresses the need for a fully endoscopic PFD technique in CM patients.

Purpose of the Study:

• To present and describe a novel full-endoscopic technique for PFD in patients with CM.
• To evaluate the feasibility and safety of this technique.

Main Methods:

• A full-endoscopic PFD technique was applied to two CM patients.
• A specialized endoscope (9.3 mm oval shaft, 177 mm length, 20° view, 5.6 mm working channel) was utilized.
• Surgical steps were guided by anatomical landmarks like the C1 posterior tubercle.

Main Results:

• The technique was successfully applied in both patients.
• Patients experienced symptom resolution and significant pain reduction (Visual Analog Scale).
• Good functional outcomes were observed, assessed by the Chicago Chiari Outcome Scale, with no complications at 6-month follow-up.

Conclusions:

• The described full-endoscopic PFD technique is feasible in clinical practice for CM patients.
• This approach aligns with previous findings from cadaveric studies.
• The technique offers a safe and effective option for PFD in CM.