Duraplasty Versus Non-dural Opening for the Treatment of Pediatric Chiari Malformation, Type I

Chiari Malformation, Type I (CMI) is characterized by the herniation of the cerebellar tonsils through the foramen magnum and into the upper cervical spinal canal. Children with CMI may present symptomatically or this entity may be found incidentally. When intervention is required, surgery, generally through posterior fossa decompression, represents first-line treatment for children with CMI. In the pediatric population, there is variability with regard to whether or not the dura is opened as a component of this procedure and if additional intradural maneuvers are performed. This chapter discusses the current literature relevant to this aspect of surgical treatment for children with CMI.