Abstract
We reported a case of scoliosis complicated with syringomyelia caused by Chiari malformation. The patient was an 11-year-old girl with scoliosis. She had been asymptomatic and had no past history until then. Radiographs revealed a 69° Cobb’s angle of scoliosis from Th4 to Th11. Syringomyelia and Chiari malformation were diagnosed by magnetic resonance imaging (MRI). The patient showed subtle neurological abnormalities such as sensory disturbance, muscle weakness of fingers, absence of superficial abdominal reflexes and hyporeflexia of the legs. Foramen magnum decompression, C1 laminoplasty and duraplasty with preservation of the arachnoid membrane were performed. Postoperatively, the size of the fistula and sensory disturbance had decreased. However, the Cobb’s angle progressed from 69° to 112° during six months after surgery. A posterior spinal correction and fusion from Th3 to L1 was performed. To avoid the risk of potential development of neurological problems due to distraction force in the spinal cord, we corrected the spinal deformity by rod rotation maneuver using Cotrel-Dubousset (CD) system. The Cobb’s angle of scoliosis changed to 37°. We believe in cases of atypical scoliotic curves, neurological examination and MRI are important means to check for the existence of Chiari malfoemation and sylingomyelia.
