{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T09:54:17Z","timestamp":1784973257087,"version":"3.55.0"},"reference-count":58,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,16]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Posterior fossa decompression is the main surgical treatment for Chiari malformation type I (CM-I). The authors present findings on patient presentation, surgical methods, and postoperative complications from a large cohort of pediatric patients with the aim of utilizing this institutional experience to guide evidence-based management of pediatric CM-I.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A departmental operative database was queried for patients who underwent a posterior fossa decompression for CM-I between 1992 and 2021. The charts of identified patients were reviewed. Data regarding demographics, presentation, operative details, and complications were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 510 patients were identified. The mean patient age was 10.2 \u00b1 5.2 years, and 57% of patients were female. The most common presenting clinical symptoms or associated signs were exertional suboccipital headaches (65%), syringomyelia (55%), and scoliosis (18%). The mean cerebellar tonsillar descent was 14.2 \u00b1 6.4 mm below the foramen magnum. At surgery, 20% of the patients with a preoperative syrinx had documented arachnoid veils obstructing the outflow tract of the fourth ventricle. Operatively, 99% of patients underwent cervical laminectomy; of these laminectomies, 89% were C1 only. Ninety-seven percent of all patients underwent suboccipital craniectomy with expansile duraplasty (PFDD), while 3% underwent bone-only decompression (PFD). Eighty-seven percent of the patients with PFDD received tonsillopexy and\/or tonsillar resection. The median postoperative hospital stay was 2 days for PFD patients and 3 days for PFDD patients (p &lt; 0.01). Postoperative complications developed in 12% of cases, with CSF leakage (5%) and aseptic meningitis (4%) being most common. CSF leakage and aseptic meningitis were also the most common reasons for early readmission after surgery. There were no intraoperative or postoperative deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The authors demonstrate an institutional preference for PFDD and tonsillopexy. Exertional suboccipital pain and syringomyelia were the most common indications for surgery. Complications tended to be more common with PFDD. There was a significant difference in postoperative length of stay between patients who underwent PFD (median 2 days) versus PFDD (median 3 days). CSF leakage and aseptic meningitis were the most common reasons for readmission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.6.peds22191","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:07Z","timestamp":1769083207000},"page":"166-172","source":"Crossref","is-referenced-by-count":1,"title":["A retrospective single-center series on the surgical management and postoperative outcomes of pediatric Chiari malformation type I. Part 1: presentation, operative management, and complications"],"prefix":"10.3171","volume":"37","author":[{"given":"Eric M.","family":"Nturibi","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin G.","family":"Piazza","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh;"},{"name":"Division of Neurological Surgery, Children\u2019s Hospital of Pittsburgh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song L.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoran","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel S.","family":"Katz","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Nationwide Children\u2019s Hospital, Colombus, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian F.","family":"Pollack","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh;"},{"name":"Division of Neurological Surgery, Children\u2019s Hospital of Pittsburgh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh;"},{"name":"Division of Neurological Surgery, Children\u2019s Hospital of Pittsburgh;"},{"name":"Department of Neurosurgery, Duke Children\u2019s Hospital, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"J Neurosurg Pediatr","first-page":"430","article-title":"Treatment practices for Chiari malformation type I with syringomyelia: results of a survey of the American Society of Pediatric Neurosurgeons","volume":"8","author":"Rocque BG","year":"2011","unstructured":"Rocque BG, George TM, Kestle J, Iskandar BJ. Treatment practices for Chiari malformation type I with syringomyelia: results of a survey of the American Society of Pediatric Neurosurgeons. J Neurosurg Pediatr. 2011;8(5):430\u2013437."},{"issue":"2","key":"b2","series-title":"J Neurosurg Pediatr","first-page":"150","article-title":"Outcomes after suboccipital decompression without dural opening in children with Chiari malformation Type I","volume":"16","author":"Kennedy BC","year":"2015","unstructured":"Kennedy BC, Kelly KM, Phan MQ,  Outcomes after suboccipital decompression without dural opening in children with Chiari malformation Type I. J Neurosurg Pediatr. 2015;16(2):150\u2013158."},{"issue":"5","key":"b3","series-title":"J Neurosurg Pediatr","first-page":"439","article-title":"The addition of duraplasty to posterior fossa decompression in the surgical treatment of pediatric Chiari malformation Type I: a systematic review and meta-analysis of surgical and performance outcomes","volume":"20","author":"Lu VM","year":"2017","unstructured":"Lu VM, Phan K, Crowley SP, Daniels DJ. The addition of duraplasty to posterior fossa decompression in the surgical treatment of pediatric Chiari malformation Type I: a systematic review and meta-analysis of surgical and performance outcomes. J Neurosurg Pediatr. 2017;20(5):439\u2013449."},{"issue":"2","key":"b4","series-title":"J Neurosurg Pediatr","first-page":"146","article-title":"Transosseous cerebrospinal fluid fistula 14 years after Chiari decompression: presentation and management","volume":"16","author":"Gandhoke GS","year":"2015","unstructured":"Gandhoke GS, Hauptman JS, Salvetti DJ,  Transosseous cerebrospinal fluid fistula 14 years after Chiari decompression: presentation and management. J Neurosurg Pediatr. 2015;16(2):146\u2013149."},{"issue":"3","key":"b5","series-title":"J Neurosurg Pediatr","first-page":"343","article-title":"Natural and surgical history of Chiari malformation Type I in the pediatric population","volume":"17","author":"Pomeraniec IJ","year":"2016","unstructured":"Pomeraniec IJ, Ksendzovsky A, Awad AJ, Fezeu F, Jane JA Jr. Natural and surgical history of Chiari malformation Type I in the pediatric population. J Neurosurg Pediatr. 2016;17(3):343\u2013352."},{"issue":"2","key":"b6","series-title":"J Neurosurg Pediatr","first-page":"208","article-title":"Trends in surgical treatment of Chiari malformation Type I in the United States","volume":"19","author":"Wilkinson DA","year":"2017","unstructured":"Wilkinson DA, Johnson K, Garton HJ, Muraszko KM, Maher CO. Trends in surgical treatment of Chiari malformation Type I in the United States. J Neurosurg Pediatr. 2017;19(2):208\u2013216."},{"issue":"3","key":"b7","series-title":"J Neurosurg Pediatr","first-page":"288","article-title":"Socioeconomic and demographic factors in the diagnosis and treatment of Chiari malformation type I and syringomyelia","volume":"29","author":"Akbari SHA","year":"2022","unstructured":"Akbari SHA, Rizvi AA, CreveCoeur TS,  Socioeconomic and demographic factors in the diagnosis and treatment of Chiari malformation type I and syringomyelia. J Neurosurg Pediatr. 2022;29(3):288\u2013297."},{"issue":"3","key":"b8","series-title":"J Neurosurg Pediatr","first-page":"248","article-title":"Institutional experience with 500 cases of surgically treated pediatric Chiari malformation Type I","volume":"7","author":"Tubbs RS","year":"2011","unstructured":"Tubbs RS, Beckman J, Naftel RP,  Institutional experience with 500 cases of surgically treated pediatric Chiari malformation Type I. J Neurosurg Pediatr. 2011;7(3):248\u2013256."},{"issue":"5","key":"b9","series-title":"Neurosurgery","first-page":"1005","article-title":"Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients","volume":"44","author":"Milhorat TH","year":"1999","unstructured":"Milhorat TH, Chou MW, Trinidad EM,  Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery. 1999;44(5):1005\u20131017."},{"issue":"3","key":"b10","series-title":"J Neurosurg Pediatr","first-page":"217","article-title":"The Chiari I malformation","volume":"24","author":"McClugage SG","year":"2019","unstructured":"McClugage SG, Oakes WJ. The Chiari I malformation. J Neurosurg Pediatr. 2019;24(3):217\u2013226."},{"issue":"6","key":"b11","series-title":"J Neurosurg Pediatr","first-page":"554","article-title":"Chiari malformation Type I in children younger than age 6 years: presentation and surgical outcome","volume":"5","author":"Albert GW","year":"2010","unstructured":"Albert GW, Menezes AH, Hansen DR, Greenlee JD, Weinstein SL. Chiari malformation Type I in children younger than age 6 years: presentation and surgical outcome. 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J Neurosurg Pediatr. 2019;24(5):520\u2013527."},{"issue":"4","key":"b13","series-title":"J Neurosurg Pediatr","first-page":"368","article-title":"Relationship of syrinx size and tonsillar descent to spinal deformity in Chiari malformation Type I with associated syringomyelia","volume":"13","author":"Godzik J","year":"2014","unstructured":"Godzik J, Kelly MP, Radmanesh A,  Relationship of syrinx size and tonsillar descent to spinal deformity in Chiari malformation Type I with associated syringomyelia. J Neurosurg Pediatr. 2014;13(4):368\u2013374."},{"issue":"2","key":"b14","series-title":"J Neurosurg Pediatr","first-page":"167","article-title":"Extradural decompression versus duraplasty in Chiari malformation type I with syrinx: outcomes on scoliosis from the Park-Reeves Syringomyelia Research Consortium","volume":"28","author":"Sadler B","year":"2021","unstructured":"Sadler B, Skidmore A, Gewirtz J,  Extradural decompression versus duraplasty in Chiari malformation type I with syrinx: outcomes on scoliosis from the Park-Reeves Syringomyelia Research Consortium. J Neurosurg Pediatr. 2021;28(2):167\u2013175."},{"issue":"5","key":"b15","series-title":"J Neurosurg Pediatr","first-page":"585","article-title":"Longitudinal scoliosis behavior in Chiari malformation with and without syringomyelia","volume":"28","author":"Chotai S","year":"2021","unstructured":"Chotai S, Nadel JL, Holste KG,  Longitudinal scoliosis behavior in Chiari malformation with and without syringomyelia. J Neurosurg Pediatr. 2021;28(5):585\u2013591."},{"issue":"2","key":"b16","series-title":"Eur Spine J","first-page":"619","article-title":"Comparison of spinal deformity in children with Chiari I malformation with and without syringomyelia: matched cohort study","volume":"25","author":"Godzik J","year":"2016","unstructured":"Godzik J, Dardas A, Kelly MP,  Comparison of spinal deformity in children with Chiari I malformation with and without syringomyelia: matched cohort study. Eur Spine J. 2016;25(2):619\u2013626."},{"key":"b17","series-title":"Clin Neurol Neurosurg","first-page":"182","article-title":"Surgical outcomes after posterior fossa decompression with and without duraplasty in Chiari malformation-I","volume":"125","author":"Chotai S","year":"2014","unstructured":"Chotai S, Medhkour A. Surgical outcomes after posterior fossa decompression with and without duraplasty in Chiari malformation-I. Clin Neurol Neurosurg. 2014;125:182\u2013188."},{"issue":"1","key":"b18","series-title":"J Neurosurg Pediatr","first-page":"39","article-title":"Complications and outcomes of posterior fossa decompression with duraplasty versus without duraplasty for pediatric patients with Chiari malformation type I and syringomyelia: a study from the Park-Reeves Syringomyelia Research Consortium","volume":"30","author":"Akbari SHA","year":"2022","unstructured":"Akbari SHA, Yahanda AT, Ackerman LL,  Complications and outcomes of posterior fossa decompression with duraplasty versus without duraplasty for pediatric patients with Chiari malformation type I and syringomyelia: a study from the Park-Reeves Syringomyelia Research Consortium. J Neurosurg Pediatr. 2022;30(1):39\u201351."},{"issue":"1","key":"b19","series-title":"J Neurosurg Pediatr","first-page":"42","article-title":"Comparison of posterior fossa decompression with and without duraplasty for the surgical treatment of Chiari malformation Type I in pediatric patients: a meta-analysis","volume":"2","author":"Durham SR","year":"2008","unstructured":"Durham SR, Fjeld-Olenec K. Comparison of posterior fossa decompression with and without duraplasty for the surgical treatment of Chiari malformation Type I in pediatric patients: a meta-analysis. J Neurosurg Pediatr. 2008;2(1):42\u201349."},{"issue":"1","key":"b20","series-title":"J Neurosurg Pediatr","first-page":"1","article-title":"Expansile duraplasty and obex exploration compared with bone-only decompression for Chiari malformation type I in children: retrospective review of outcomes and complications","volume":"27","author":"Ene CI","year":"2021","unstructured":"Ene CI, Wang AC, Collins KL,  Expansile duraplasty and obex exploration compared with bone-only decompression for Chiari malformation type I in children: retrospective review of outcomes and complications. J Neurosurg Pediatr. 2021;27(1):1\u20138."},{"issue":"6","key":"b21","series-title":"Neurosurgery","first-page":"1384","article-title":"Effects of posterior fossa decompression with and without duraplasty on Chiari malformation-associated hydromyelia","volume":"46","author":"Munshi I","year":"2000","unstructured":"Munshi I, Frim D, Stine-Reyes R, Weir BK, Hekmatpanah J, Brown F. 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Arachnoid veils and the Chiari I malformation. J Neurosurg. 2004;100(5 Suppl Pediatrics):465\u2013467."},{"issue":"6","key":"b28","series-title":"J Neurosurg Pediatr","first-page":"526","article-title":"Intradural pathology and pathophysiology associated with Chiari I malformation in children and adults with and without syringomyelia","volume":"20","author":"Dlouhy BJ","year":"2017","unstructured":"Dlouhy BJ, Dawson JD, Menezes AH. Intradural pathology and pathophysiology associated with Chiari I malformation in children and adults with and without syringomyelia. J Neurosurg Pediatr. 2017;20(6):526\u2013541."},{"issue":"2","key":"b29","series-title":"J Neurosurg Pediatr","first-page":"161","article-title":"Pediatric and adult Chiari malformation Type I surgical series 1965\u20132013: a review of demographics, operative treatment, and outcomes","volume":"15","author":"Arnautovic A","year":"2015","unstructured":"Arnautovic A, Splavski B, Boop FA, Arnautovic KI. 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The addition of duraplasty to posterior fossa decompression in the surgical treatment of pediatric Chiari malformation Type I: a systematic review and meta-analysis of surgical and performance outcomes. J Neurosurg Pediatr. 2017;20(5):439\u2013449."},{"issue":"2","key":"b4","series-title":"J Neurosurg Pediatr","first-page":"146","article-title":"Transosseous cerebrospinal fluid fistula 14 years after Chiari decompression: presentation and management","volume":"16","author":"Gandhoke GS","year":"2015","unstructured":"Gandhoke GS, Hauptman JS, Salvetti DJ,  Transosseous cerebrospinal fluid fistula 14 years after Chiari decompression: presentation and management. J Neurosurg Pediatr. 2015;16(2):146\u2013149."},{"issue":"3","key":"b5","series-title":"J Neurosurg Pediatr","first-page":"343","article-title":"Natural and surgical history of Chiari malformation Type I in the pediatric population","volume":"17","author":"Pomeraniec IJ","year":"2016","unstructured":"Pomeraniec IJ, Ksendzovsky A, Awad AJ, Fezeu F, Jane JA Jr. Natural and surgical history of Chiari malformation Type I in the pediatric population. J Neurosurg Pediatr. 2016;17(3):343\u2013352."},{"issue":"2","key":"b6","series-title":"J Neurosurg Pediatr","first-page":"208","article-title":"Trends in surgical treatment of Chiari malformation Type I in the United States","volume":"19","author":"Wilkinson DA","year":"2017","unstructured":"Wilkinson DA, Johnson K, Garton HJ, Muraszko KM, Maher CO. Trends in surgical treatment of Chiari malformation Type I in the United States. 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J Neurosurg Pediatr. 2021;28(5):585\u2013591."},{"issue":"2","key":"b16","series-title":"Eur Spine J","first-page":"619","article-title":"Comparison of spinal deformity in children with Chiari I malformation with and without syringomyelia: matched cohort study","volume":"25","author":"Godzik J","year":"2016","unstructured":"Godzik J, Dardas A, Kelly MP,  Comparison of spinal deformity in children with Chiari I malformation with and without syringomyelia: matched cohort study. Eur Spine J. 2016;25(2):619\u2013626."},{"key":"b17","series-title":"Clin Neurol Neurosurg","first-page":"182","article-title":"Surgical outcomes after posterior fossa decompression with and without duraplasty in Chiari malformation-I","volume":"125","author":"Chotai S","year":"2014","unstructured":"Chotai S, Medhkour A. Surgical outcomes after posterior fossa decompression with and without duraplasty in Chiari malformation-I. 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Effects of posterior fossa decompression with and without duraplasty on Chiari malformation-associated hydromyelia. Neurosurgery. 2000;46(6):1384\u20131390."},{"issue":"1","key":"b22","series-title":"J Neurosurg Pediatr","first-page":"52","article-title":"Intraoperative ultrasonography as a guide to patient selection for duraplasty after suboccipital decompression in children with Chiari malformation Type I","volume":"2","author":"McGirt MJ","year":"2008","unstructured":"McGirt MJ, Attenello FJ, Datoo G,  Intraoperative ultrasonography as a guide to patient selection for duraplasty after suboccipital decompression in children with Chiari malformation Type I. 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Pediatr Neurosurg. 1997;27(5):272\u2013275."},{"issue":"2","key":"b25","series-title":"J Neurosurg Pediatr","first-page":"193","article-title":"Timing of syrinx reduction and stabilization after posterior fossa decompression for pediatric Chiari malformation type I","volume":"26","author":"Chotai S","year":"2020","unstructured":"Chotai S, Chan EW, Ladner TR,  Timing of syrinx reduction and stabilization after posterior fossa decompression for pediatric Chiari malformation type I. 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Arachnoid veils and the Chiari I malformation. J Neurosurg. 2004;100(5 Suppl Pediatrics):465\u2013467."},{"issue":"6","key":"b28","series-title":"J Neurosurg Pediatr","first-page":"526","article-title":"Intradural pathology and pathophysiology associated with Chiari I malformation in children and adults with and without syringomyelia","volume":"20","author":"Dlouhy BJ","year":"2017","unstructured":"Dlouhy BJ, Dawson JD, Menezes AH. Intradural pathology and pathophysiology associated with Chiari I malformation in children and adults with and without syringomyelia. J Neurosurg Pediatr. 2017;20(6):526\u2013541."},{"issue":"2","key":"b29","series-title":"J Neurosurg Pediatr","first-page":"161","article-title":"Pediatric and adult Chiari malformation Type I surgical series 1965\u20132013: a review of demographics, operative treatment, and outcomes","volume":"15","author":"Arnautovic A","year":"2015","unstructured":"Arnautovic A, Splavski B, Boop FA, Arnautovic KI. 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