Posterior Fossa Decompression with or Without Duraplasty for Chiari I Malformation.

Posterior fossa decompression (PFD) with/without duraplasty is the standard surgical treatment for symptomatic CM-1. Posterior fossa decompression without duraplasty (PFD) may be associated with shorter operative times and hospital stays, fewer complications, and may yield improvements in symptoms and syrinx sizes. Posterior fossa decompression with duraplasty (PFDD) may be associated with superior long-term symptomatic improvements, larger syrinx reductions, and a lower need for revision decompression. Various dural graft materials may be used for PFDD, though the ideal type of graft has not been definitively established. Other adjunct surgical procedures may be added to PFD/PFDD given certain symptomatic or anatomical considerations.