{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:46:36Z","timestamp":1789670796460,"version":"4.0.1"},"reference-count":42,"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>Chiari decompression is the definitive treatment for symptomatic Chiari malformation type I (CM-I). In part 1 of this two-part series, operative management and perioperative complications were discussed. Presented here are the symptomatic outcomes from a large cohort of pediatric patients who underwent Chiari decompression.<\/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 Chiari decompression between 1992 and 2021; 510 patients were identified. Data regarding patient outcomes were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Seventy-three percent of patients with exertional suboccipital headaches and 67% of patients with central sleep apnea reported improvement, while 77% of patients with syringomyelia and postoperative imaging exhibited a reduction in the length or diameter of the syrinx after decompressive surgery. Among the 32 patients with syringomyelia as an indication for repeat surgery, 18 (56%) had structural causes of syrinx formation or persistence identified on preoperative imaging and all had structural causes identified intraoperatively. Postoperative complications requiring readmission after revision surgery occurred in 18% of patients, slightly higher than with primary Chiari decompression (11%), although the most common complications remained CSF leakage and aseptic meningitis. Nine percent of patients required repeat decompression due to worsening or new Chiari symptoms or persistent syringomyelia, with a median time to repeat surgery of 17 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The authors present an institutional experience with Chiari decompression. Both initial and revision decompressive surgeries were predominantly performed as posterior fossa decompression with duraplasty and tonsillopexy and demonstrated high rates of postoperative symptomatic and radiographic improvement. Revision surgery was necessary in &lt; 10% of patients, most commonly due to syrinx persistence or formation secondary to intradural scarring from the initial surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.6.peds22192","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:06Z","timestamp":1769083206000},"page":"173-179","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 2: symptomatic outcomes and revision surgery"],"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","first-page":"1356","article-title":"Outcomes for various dural graft materials after posterior fossa decompression with duraplasty for Chiari malformation type I: a systematic review and meta-analysis","volume":"135","author":"Yahanda AT","year":"2021","unstructured":"Yahanda AT, Simon LE, Limbrick DD. Outcomes for various dural graft materials after posterior fossa decompression with duraplasty for Chiari malformation type I: a systematic review and meta-analysis. J Neurosurg. 2021;135(5):1356\u20131369."},{"issue":"2","key":"b2","series-title":"J Neurosurg","first-page":"291","article-title":"Surgical experience in 130 pediatric patients with Chiari I malformations","volume":"99","author":"Tubbs RS","year":"2003","unstructured":"Tubbs RS, McGirt MJ, Oakes WJ. Surgical experience in 130 pediatric patients with Chiari I malformations. J Neurosurg. 2003;99(2):291\u2013296."},{"key":"b3","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":"b4","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":"1","key":"b5","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":"3","key":"b6","series-title":"J Neurosurg Pediatr","first-page":"296","article-title":"Central sleep apnea and associated Chiari malformation in children with syndromic craniosynostosis: treatment and outcome data from a supraregional national craniofacial center","volume":"11","author":"Addo NK","year":"2013","unstructured":"Addo NK, Javadpour S, Kandasamy J, Sillifant P, May P, Sinha A. Central sleep apnea and associated Chiari malformation in children with syndromic craniosynostosis: treatment and outcome data from a supraregional national craniofacial center. J Neurosurg Pediatr. 2013;11(3):296\u2013301."},{"issue":"8","key":"b7","series-title":"Neurology","first-page":"1080","article-title":"Creutzfeldt-Jakob disease after receipt of a previously unimplicated brand of dura mater graft","volume":"56","author":"Hannah EL","year":"2001","unstructured":"Hannah EL, Belay ED, Gambetti P,  Creutzfeldt-Jakob disease after receipt of a previously unimplicated brand of dura mater graft. Neurology. 2001;56(8):1080\u20131083."},{"issue":"4","key":"b8","series-title":"J Neurosurg Pediatr","first-page":"459","article-title":"Dural augmentation approaches and complication rates after posterior fossa decompression for Chiari I malformation and syringomyelia: a Park-Reeves Syringomyelia Research Consortium study","volume":"27","author":"Yahanda AT","year":"2021","unstructured":"Yahanda AT, Adelson PD, Akbari SHA,  Dural augmentation approaches and complication rates after posterior fossa decompression for Chiari I malformation and syringomyelia: a Park-Reeves Syringomyelia Research Consortium study. 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Pediatr Neurosurg. 2003;38(4):186\u2013190."},{"issue":"6","key":"b15","series-title":"Pediatr Neurosurg","first-page":"323","article-title":"Bone regrowth and recurrence of symptoms following decompression in the infant with Chiari II malformation","volume":"23","author":"Hudgins RJ","year":"1995","unstructured":"Hudgins RJ, Boydston WR. Bone regrowth and recurrence of symptoms following decompression in the infant with Chiari II malformation. Pediatr Neurosurg. 1995;23(6):323\u2013327."},{"issue":"3 Suppl","key":"b16","series-title":"J Neurosurg","first-page":"187","article-title":"The role of limited posterior fossa craniectomy in the surgical treatment of Chiari malformation Type I: experience with a pediatric series","volume":"106","author":"Caldarelli M","year":"2007","unstructured":"Caldarelli M, Novegno F, Vassimi L, Romani R, Tamburrini G, Di Rocco C. 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Childs Nerv Syst. 2022;38(8):1621\u20131624."},{"issue":"2","key":"b19","series-title":"Neurosurgery","first-page":"340","article-title":"Spontaneous regeneration of the foramen magnum after decompressive suboccipital craniectomy in Chiari malformation: case report","volume":"37","author":"Aoki N","year":"1995","unstructured":"Aoki N, Oikawa A, Sakai T. Spontaneous regeneration of the foramen magnum after decompressive suboccipital craniectomy in Chiari malformation: case report. Neurosurgery. 1995;37(2):340\u2013342."},{"issue":"1","key":"b20","series-title":"Surg Neurol","first-page":"83","article-title":"C1 arch regeneration, tight cisterna magna, and cervical syringomyelia following foramen magnum surgery","volume":"72","author":"Rahme R","year":"2009","unstructured":"Rahme R, Koussa S, Samaha E. C1 arch regeneration, tight cisterna magna, and cervical syringomyelia following foramen magnum surgery. Surg Neurol. 2009;72(1):83\u201386."},{"issue":"2","key":"b21","series-title":"Plast Reconstr Surg","first-page":"515","article-title":"Osteogenesis in calvarial defects: contribution of the dura, the pericranium, and the surrounding bone in adult versus infant animals","volume":"112","author":"Gosain AK","year":"2003","unstructured":"Gosain AK, Santoro TD, Song LS, Capel CC, Sudhakar PV, Matloub HS. Osteogenesis in calvarial defects: contribution of the dura, the pericranium, and the surrounding bone in adult versus infant animals. Plast Reconstr Surg. 2003;112(2):515\u2013527."},{"issue":"5","key":"b1","series-title":"J Neurosurg","first-page":"1356","article-title":"Outcomes for various dural graft materials after posterior fossa decompression with duraplasty for Chiari malformation type I: a systematic review and meta-analysis","volume":"135","author":"Yahanda AT","year":"2021","unstructured":"Yahanda AT, Simon LE, Limbrick DD. Outcomes for various dural graft materials after posterior fossa decompression with duraplasty for Chiari malformation type I: a systematic review and meta-analysis. J Neurosurg. 2021;135(5):1356\u20131369."},{"issue":"2","key":"b2","series-title":"J Neurosurg","first-page":"291","article-title":"Surgical experience in 130 pediatric patients with Chiari I malformations","volume":"99","author":"Tubbs RS","year":"2003","unstructured":"Tubbs RS, McGirt MJ, Oakes WJ. Surgical experience in 130 pediatric patients with Chiari I malformations. J Neurosurg. 2003;99(2):291\u2013296."},{"key":"b3","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":"b4","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":"1","key":"b5","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":"3","key":"b6","series-title":"J Neurosurg Pediatr","first-page":"296","article-title":"Central sleep apnea and associated Chiari malformation in children with syndromic craniosynostosis: treatment and outcome data from a supraregional national craniofacial center","volume":"11","author":"Addo NK","year":"2013","unstructured":"Addo NK, Javadpour S, Kandasamy J, Sillifant P, May P, Sinha A. Central sleep apnea and associated Chiari malformation in children with syndromic craniosynostosis: treatment and outcome data from a supraregional national craniofacial center. J Neurosurg Pediatr. 2013;11(3):296\u2013301."},{"issue":"8","key":"b7","series-title":"Neurology","first-page":"1080","article-title":"Creutzfeldt-Jakob disease after receipt of a previously unimplicated brand of dura mater graft","volume":"56","author":"Hannah EL","year":"2001","unstructured":"Hannah EL, Belay ED, Gambetti P,  Creutzfeldt-Jakob disease after receipt of a previously unimplicated brand of dura mater graft. Neurology. 2001;56(8):1080\u20131083."},{"issue":"4","key":"b8","series-title":"J Neurosurg Pediatr","first-page":"459","article-title":"Dural augmentation approaches and complication rates after posterior fossa decompression for Chiari I malformation and syringomyelia: a Park-Reeves Syringomyelia Research Consortium study","volume":"27","author":"Yahanda AT","year":"2021","unstructured":"Yahanda AT, Adelson PD, Akbari SHA,  Dural augmentation approaches and complication rates after posterior fossa decompression for Chiari I malformation and syringomyelia: a Park-Reeves Syringomyelia Research Consortium study. J Neurosurg Pediatr. 2021;27(4):459\u2013468."},{"issue":"6","key":"b9","series-title":"Br J Neurosurg","first-page":"750","article-title":"Experience with revision craniovertebral decompression in adult patients with Chiari malformation type 1, with or without syringomyelia. 1","volume":"36","author":"Silva A","year":"2022","unstructured":"Silva A, Thanabalasundaram G, Wilkinson B, Tsermoulas G, Flint G. Experience with revision craniovertebral decompression in adult patients with Chiari malformation type 1, with or without syringomyelia. 1. Br J Neurosurg. 2022;36(6):750\u2013755."},{"issue":"3","key":"b10","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 Suppl Pediatrics","key":"b11","series-title":"J Neurosurg","first-page":"460","article-title":"Persistent syringomyelia following pediatric Chiari I decompression: radiological and surgical findings","volume":"100","author":"Tubbs RS","year":"2004","unstructured":"Tubbs RS, Webb DB, Oakes WJ. Persistent syringomyelia following pediatric Chiari I decompression: radiological and surgical findings. J Neurosurg. 2004;100(5 Suppl Pediatrics):460-464."},{"issue":"6","key":"b12","series-title":"Clinical article. J Neurosurg Spine","first-page":"729","article-title":"Pathophysiology of persistent syringomyelia after decompressive craniocervical surgery","volume":"13","author":"Heiss JD","year":"2010","unstructured":"Heiss JD, Suffredini G, Smith R,  Pathophysiology of persistent syringomyelia after decompressive craniocervical surgery. Clinical article. J Neurosurg Spine. 2010;13(6):729\u2013742."},{"issue":"6","key":"b13","series-title":"J Neurosurg Pediatr","first-page":"538","article-title":"Neurological deterioration after foramen magnum decompression for Chiari malformation type I: old or new pathology?","volume":"10","author":"Klekamp J","year":"2012","unstructured":"Klekamp J. Neurological deterioration after foramen magnum decompression for Chiari malformation type I: old or new pathology? J Neurosurg Pediatr. 2012;10(6):538\u2013547."},{"issue":"4","key":"b14","series-title":"Pediatr Neurosurg","first-page":"186","article-title":"Recurrence of symptoms after Chiari decompression and duraplasty with nonautologous graft material","volume":"38","author":"Rosen DS","year":"2003","unstructured":"Rosen DS, Wollman R, Frim DM. Recurrence of symptoms after Chiari decompression and duraplasty with nonautologous graft material. Pediatr Neurosurg. 2003;38(4):186\u2013190."},{"issue":"6","key":"b15","series-title":"Pediatr Neurosurg","first-page":"323","article-title":"Bone regrowth and recurrence of symptoms following decompression in the infant with Chiari II malformation","volume":"23","author":"Hudgins RJ","year":"1995","unstructured":"Hudgins RJ, Boydston WR. Bone regrowth and recurrence of symptoms following decompression in the infant with Chiari II malformation. Pediatr Neurosurg. 1995;23(6):323\u2013327."},{"issue":"3 Suppl","key":"b16","series-title":"J Neurosurg","first-page":"187","article-title":"The role of limited posterior fossa craniectomy in the surgical treatment of Chiari malformation Type I: experience with a pediatric series","volume":"106","author":"Caldarelli M","year":"2007","unstructured":"Caldarelli M, Novegno F, Vassimi L, Romani R, Tamburrini G, Di Rocco C. The role of limited posterior fossa craniectomy in the surgical treatment of Chiari malformation Type I: experience with a pediatric series. J Neurosurg. 2007;106(3 Suppl):187-195."},{"issue":"4","key":"b17","series-title":"Pediatr Neurosurg","first-page":"171","article-title":"Reoperation for Chiari malformations","volume":"39","author":"Sacco D","year":"2003","unstructured":"Sacco D, Scott RM. Reoperation for Chiari malformations. Pediatr Neurosurg. 2003;39(4):171\u2013178."},{"issue":"8","key":"b18","series-title":"Childs Nerv Syst","first-page":"1621","article-title":"Dural sac restenosis due to regeneration of the resected C1 lamina in a patient with Chiari malformation: a case report and literature review","volume":"38","author":"Kitamura S","year":"2022","unstructured":"Kitamura S, Ito K, Horiuchi T. Dural sac restenosis due to regeneration of the resected C1 lamina in a patient with Chiari malformation: a case report and literature review. 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