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elizar
01-03-2013, 07:02 PM
Hi Dr Scoliosis,

I am 27 with around 80 degree scoliosis and plan to have deformity correction surgery. 4 weeks ago my surgeon found that I have Chiari Malformation (Type 1) with syrinx. Then my surgeon said the spine surgery can't be done unless the Chiari is treated first.

I was too shocked at that time and wasn't quite clear about the reason why spine surgery can't be done without fixing the chiari first.

Would you please explain the reason behind it?

Thanks
Elizar

Dr Scoliosis
02-03-2013, 05:41 PM
Thank you for your enquiry. Without specific details I can only give you information on general principles.

An Arnold Chiari malformation (Type I) is where part of the hind brain which is linked with muscular control extrudes out of the skull adjacent to the spinal cord. That abnormality may exist alone. However, it is often associated with a syrinx which is a long dilated cyst-like structure within the spinal cord.

There is no question that a syrinx can be associated with a scoliosis. Not all patients with a syrinx have an Arnold Chiari malformation and vice versa. The actual cause of the scoliosis is not precisely delineated. However, it is known that when there is a significant Arnold Chiari malformation and/or a syrinx then correction of the curve without attending to the syrinx or the Arnold Chiari malformation first may result in significant neurological deterioration. Correction of the curve will involve straightening it and that makes it longer which can result in the cerebellar extension into the spinal canal increasing with neurological deterioration. Hence, it is a standard approach that the Arnold Chiari malformation and the syrinx, either alone or in combination, should be corrected before the definitive deformity surgery.

I trust this information is helpful.

Dr Scoliosis

elizar
06-03-2013, 12:29 PM
Dear Dr Scoliosis,

Thanks for the quick and informative reply.
I have a better idea about it now

Elizar