Complications Similar for Decompression With or Without Duraplasty for Chiari I and Syringomyelia

MONDAY, June 8, 2026 (HealthDay News) — For children with Chiari type I malformation and syringomyelia, surgical complications do not differ for those undergoing neurosurgical posterior fossa decompression (PFD) with duraplasty (PFD-D) versus PFD alone, according to a study published in the May 28 issue of the New England Journal of Medicine.

David D. Limbrick Jr., M.D., Ph.D., from the Virginia Commonwealth University School of Medicine in Richmond, and colleagues conducted a multicenter, cluster-randomized, controlled trial of PFD-D versus PFD alone among patients aged 21 years or younger with cerebellar tonsillar ectopia of at least 5 mm and a maximum syrinx diameter of 3.0 to 9.9 mm. The trial included 162 participants; 78 and 84 were assigned to undergo PFD-D and PFD alone, respectively.

The researchers found that 14 and 6 percent of participants in the PFD-D and PFD groups, respectively, had complications within six months (adjusted odds ratio, 2.59; 95 percent confidence interval, 0.86 to 7.84; P = 0.11). The percentage of participants with clinical improvement at 24 months was 58 and 46 percent with PFD-D and PFD, respectively; the mean syrinx reduction was 3.08 ± 2.33 mm and 1.22 ± 1.79 mm, respectively, and 3 and 14 percent of patients, respectively, had repeat decompression. The two groups had similar changes in health-related quality of life.

“Syrinx resolution is an important metric, because the number one reason people go back for second surgery is because the syrinx didn”t respond,” Limbrick said in a statement.

Several authors disclosed ties to the biomedical industry.

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