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

Chiari malformation type I (CM I) is characterized by the herniation of the cerebellar tonsils through the foramen magnum and into the upper cervical spinal canal. Children with CM I 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 CM I. 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 CM I.