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Craniocervical spinal instability after type 1 Arnold Chiari decompression: a case report

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To present and describe an unusual case of spinal instability after craniocervical spinal decompression for a type-1 Chiari malformation. Type-1 Chiari malformation is a craniocervical disorder characterized by tonsillar displacement greater than 5 mm into the vertebral canal; posterior fossa decompression is the most common surgical treatment for this condition. Postoperative complications have been described: cerebrospinal fluid leak, pseudomeningocele, aseptic meningitis, wound infection, and neurological deficit. However, instability after decompression is unusual. A 9-year-old female presented with symptomatic torticollis after cervical decompression for a type-1 Chiari malformation. Spinal instability was diagnosed; craniocervical stabilization was performed. After a 12-month follow-up, spinal stability was achieved, with a satisfactory clinical neck alignment. We present a craniocervical instability secondary to surgical decompression; clinical and radiological symptoms, and definitive treatment were described.
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Keywords: Arnold Chiari complications; Arnold Chiari malformation; Arnold–Chiari treatment; cervical fixation; cervical instability; craniocervical disorder; craniocervical instability; posterior fossa decompression; spinal instability; vertebral artery injury

Document Type: Research Article

Affiliations: Hospital Italiano de Buenos Aires, Orthopaedics Institute ‘Prof Dr Carlos E Ottolenghi’, Buenos Aires, Argentina

Publication date: January 1, 2017

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