Abstract
A 16-year-old male suffering from backache was admitted to our hospital. Chest roentgenogram showed thoracic scoliosis. MR image of the brain revealed tonsillar herniation into the level of C1. Cervical spine MR image showed a syrinx in the spinal cord below the C5 level. The patient was diagnosed with Chiari malformation type I associated with syringomyelia, which had induced a scoliotic change of the vertebrae. He underwent suboccipital craniectomy, C1-C2 laminectomy, and dural plasty. Postoperatively his symptom diminished gradually and six months later his scoliosis had remarkably improved. Postoperative brain MR image showed expansion of the cisterna magna, and cervical MR image demonstrated the markedly reduced syrinx nine months after as well. Foramen magnum decompression would have facilitated the flow of cerebrospinal fluid at the craniocervical junction and served to resolve syringomyelia. The imbalance of the paravertebral muscles was thought to be corrected, thereby improving the scoliosis. Syringo-subarachnoid shunting operation was not needed.
