Short-Term Outcomes of Posterior Fossa Decompression with or without Duraplasty for Chiari Malformation Type 1: Insights from a Tertiary Care Hospital

Abstract

Objectives: To assess and compare short-term outcomes of patients who underwent posterior fossa decompression with and without duraplasty for Chiari Malformation Type 1 (CM1). Methodology: This retrospective cohort study was conducted at Khyber Teaching Hospital's Peshawar, Pakistan, in December 2023 after securing permission from the Institutional Review Board (IRB) with reference. We included patients who underwent posterior fossa decompression for Chiari Malformation Type 1 (CM1) over a one-year period from March 2022 to March 2023 at Khyber Teaching Hospital. Retrospective data of specified duration concerning CM1 Patient’s demographics, preoperative symptoms, surgical details including the use of duraplasty, and postoperative outcomes were extracted from electronic health records at Khyber Teaching Hospital, Peshawar. Data was analyzed by SPSS27. Descriptive statistics were employed to summarize demographic characteristics and baseline clinical data and frequencies were reported.Comparative analyses between posterior fossa decompression surgery with duraplasty and that without duraplasty groups were performed using t-tests for continuous variables and chi-square tests for categorical variables. Results: 52 patients were included in our study out of which 28 underwent posterior fossa decompression with duraplasty and 24 without duraplasty. 8 patients (15.4%) experienced postoperative complications. Cerebrospinal fluid leaks were observed in 3 cases (5.8%), all of which occurred in the PFD with duraplasty group. The mean length of hospital stay for patients undergoing PFD with duraplasty was 6.2 days (SD ± 1.4), while for those undergoing PFD without duraplasty, it was 5.4 days (SD ± 0.9). Conclusion: Posterior fossa decompression with duraplasty carries the risk of CSF leak so the preferred procedure for Chiari Malformation Type 1 is posterior fossa decompression without duroplasty. Those patients requiring posterior fossa decompression with duroplasty should be highly individualized.