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Although the exact surgical technique varies among individual surgeons, the goals of surgery remain constant and consist of relieving brainstem compression and cranial nerve distortion, restoring the normal flow of CSF across the foramen magnum, and reducing the size of any associated syrinx cavity. Syrinx cavities are most commonly associated with Chiari anomalies, yet primary spinal syringomyelia (PSS) can be caused by traumatic, infectious, degenerative, and other etiologies that cause at least a partial CSF flow obstruction in the spinal subarachnoid space. As with syringomyelia associated with Chiari anomalies, the main goal of PSS surgery is to reestablish CSF flow across the area of obstruction. In addition to MRI, myelography with CT can be very helpful in the evaluation and management of these patients by identifying focal regions of CSF obstruction that may be amenable to surgical intervention. Future directions for the treatment of Chiari anomalies and syringomyelia include the application of advanced imaging techniques, more widespread use of genetic evaluation, large-scale outcome studies, and the further refinement of surgical technique.<\/jats:p>","DOI":"10.3171\/2019.7.spine181139","type":"journal-article","created":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T18:57:51Z","timestamp":1572634671000},"page":"619-628","source":"Crossref","is-referenced-by-count":85,"title":["Chiari malformation and syringomyelia"],"prefix":"10.3171","volume":"31","author":[{"given":"Langston T.","family":"Holly","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Batzdorf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"460","DOI":"10.3171\/2016.9.JNS161274","article-title":"Population-based description of familial clustering of Chiari malformation Type I","volume":"128","author":"Abbott D","year":"2018","unstructured":"Abbott D, Brockmeyer D, Neklason DW, Teerlink C, Cannon-Albright LA: Population-based description of familial clustering of Chiari malformation Type I. 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