Scoliosis in adult Type 1 Chiari malformation with syringomyelia patients: from pathogenesis to treatment

Type 1 Chiari malformation (CIM) involves the herniation of the cerebellar tonsil into the upper cervical spine. This can lead to nerve damage and other complications. Scoliosis is a common spinal deformity in CIM patients, often requiring surgery. The link between Chiari malformation, syringomyelia, and scoliosis is still under investigation. Surgery for scoliosis in CIM-SM patients is high-risk. This review explores whether intervention for Chiari malformation and syringomyelia should precede spinal orthopaedic surgery.

• 1
  Adult CIM patients often have more severe clinical manifestations, including brainstem and cranial nerve compression, leading to scoliosis deformities being overlooked.
• 2
  The theory of posterior cranial fossa incompatibility suggests that congenital dysplasia leads to overcrowding and herniation, potentially resulting in syringomyelia and hydrocephalus.
• 3
  4D Flow MRI shows promise in evaluating cerebrospinal fluid (CSF) flow patterns in CIM-SM patients, suggesting syringomyelia may result from abnormal CSF circulation.