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Glendale, CA 91206
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Effect of Foramen Magnum Decompression on Neck Motion

Posted on: 11/30/1999
Patients with syringomyelia with Chiari malformation-Type I (CM-I) were the subject of this study. With CM-I, the lower part of the cerebellum protrudes from its normal location in the back of the head.

The cerebellum is a separate, smaller part of the brain located at the base of the skull. It is just above the cervical spine (neck). It slides down into the cervical portion of the spinal canal. These patients develop syrinx in the cervical spine.

The syrinx is a cyst or tube-shaped cavity that forms within the spinal cord. Syringomyelia is the general term used to describe this cyst formation. The syrinx can expand and get longer. It can destroy the center of the spinal cord.

In this study, neck motion was studied in relation to the degree of severity of the syrinx. It's possible that motion is restricted with more severe deformity. Although all levels of cervical motion were studied, the focus was on the occipitocervical region. This is where the occiput (base of the skull) and first two cervical bones (C1 and C2) meet.

Patients included all had surgery for CM-I with syringomyelia. A foramen magnum decompression (FMD) was done. In FMD, the bone around the spinal cord is removed. Pressure is taken off the brain and spinal cord.

Range of motion was measured before and after the operation for each patient. The results showed no difference in neck motion between pre- and post-operative measures.

FMD is an effective treatment method for pain relief but doesn't change motion in patients with CM-I. It does not appear that the severity of CM-I is linked with the loss of motion seen in the occipitocervical region. The authors suggest further study of this question is needed with a larger number of patients.

Atsushi Ono, MD, PhD, et al. Cervical Spinal Motion Before and After Surgery in Patients with Chiari Malformation Type I Associated with Syringomyelia. In Journal of Neurosurgery: Spine. November 2007. Vol. 7. No. 5. Pp. 473-477.

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