Clinical results of decompression and single layer duroplasty with vertical incision in TYPE-1 chiari malformations

In the surgical treatment of Chiari type I malformation; decompression, post-decompression duroplasty and durasplit technique are used. In addition, as in our surgical technique, only the parietal leaf of the dura is opened with vertical incisions and accordion-shaped dural expansion is achieved. This procedure makes a significant contribution to reducing the risk of CSF fistula, cerebellum and brain stem herniation. In this direction, the aim of our research is; to evaluate retrospectively the clinical and radiological results of patients with chiari type 1 malformation who was performed single-layer duroplasty with decompression and vertical incision to reduce the risk of CSF fistula, cerebellum and brain stem herniation, unlike duroplasty and durasplit technique. Research the study was conducted with 13 male and 21 female patients diagnosed as Chiari Type I, with the permission of Manisa Celal Bayar University Faculty of Medicine, Clinical Research Ethics Committee, dated and numbered 04.01.2022-E.220530. After decompression and dural expansion were performed, the clinical features of the patients were evaluated with Chicago Chiari scale, VAS and Neck disability index. While the mean age of the patients was 33.91±10.86, the preoperative VAS was 7.88, the postoperative VAS was 3.21, and the Chicago chiari -postop 6th month result was 13.97. While the preoperative score from the neck disability questionnaire was 23.50, it was found to be 12.03 at the postoperative 6th month and 11.50 at the 1st year. As a result of the research, it was determined that suboccipital pain, joint pain, numbness in the extremity, instability, contraction in the extremity, sleep apnea and cerebellar findings decreased in the postoperative period with statistical significance (p<0.05). It was determined that low complication rates and good surgical results were obtained with the single layer duroplasty technique with decompression and vertical incision we applied.