• Enze Jiang, Shifu Sha, XinXin Yuan, WeiGuo Zhu, Jian Jiang, Hongbin Ni, Zhen Liu, Yong Qiu, and Zezhang Zhu.
• Department of Spine Surgery, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
• World Neurosurg. 2018 Feb 1; 110: e465-e472.

ObjectiveThe aim of this study was to prospectively compare the radiographic and clinical outcomes between the posterior fossa decompression (PFD) and PFD with duraplasty (PFDD) procedures in adolescent patients with Chiari malformation type I (CMI).MethodsNinety adolescent patients with CMI were randomly assigned to undergo either PFDD or PFD. In both groups, a dissection from the occipital bone was performed. The dura was not opened in the PFD group, and the outer layer of dura was resected. However, in the PFDD group, the dura mater was opened and expanded. Data were analyzed for clinical outcome, complications, and syrinx resolution.ResultsThe age, gender, and preoperative neurologic status were similar between the 2 groups. Compared with the PFD group, patients undergoing PFDD had significantly longer operation time, longer postoperative drainage time, and higher drainage volume. At the latest follow-up, no statistically significant difference was found between the 2 groups in terms of syrinx resolution. The clinical outcomes were similar in the PFDD and PFD group. Compared with the PFD group, patients in the PFDD group had a higher incidence of cerebrospinal fluid leak.ConclusionsCompared with the more aggressive decompression with duraplasty, PFD without duraplasty produces comparable radiologic and clinical outcomes and is associated with a lower risk of complications.Copyright © 2017 Elsevier Inc. All rights reserved.

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