The Impact of Foramen Magnum Decompression With versus Without Duraplasty on Symptom Improvement and Syrinx Reduction in Chiari 1 Malformation Patients.

Introduction: Surgical decompression is considered the gold standard of treatment for patients with Chiari 1 malformation who are symptomatic or with syrinx. Currently, foramen magnum decompression with duraplasty (FMDD) and without duraplasty (FMD) are the two most commonly used techniques. This retrospective analysis aims to compare clinical improvement and syrinx reduction in patients undergoing FMDD versus FMD. Materials and Methods: Clinical and radiological assessments were conducted pre- and postoperatively. Patient data was collected from electronic records and analyzed using univariate and multivariate regression analysis in R. Results: Fifty-eight patients underwent FMDD and 38 patients underwent FMD. No difference in likelihood for symptom improvement (adjusted odds ratio [aOR] 0.96, Conclusion: No differences in overall symptom improvement or syrinx reduction were seen between patients undergoing FMD and FMDD. However, patients undergoing FMDD had longer lengths of stay in hospital. The lack of difference in symptom improvement and syrinx reduction may promote FMD as a better surgical technique. Furthermore, the role for individual symptoms in predicting symptom improvement and syrinx reduction was demonstrated. Larger studies will be required to validate which technique is better suited for patients with Chiari 1 malformations and to investigate the role of symptoms in predicting outcomes.