The Impact of Syrinx on Clinical Outcomes in Arnold-Chiari Malformation: A Retrospective Study

Abstract

Objective: Arnold-Chiari malformation is congenital or acquired anomaly of the hindbrain that leads to crowding of the cerebellum and brainstem in the posterior cranial fossa. There is an interplay between syringomyelia and Arnold-Chiari malformation. The objective of this study was to analyse the incidence trends, morphological patterns, and clinical outcomes of Arnold-Chiari malformation with and without syringomyelia, focusing on patients treated at Hayatabad Medical Complex, Peshawar.

Methodology: This retrospective study was conducted on 150 patients from January 2023 to December 2023. Patients were divided into two groups: 75 with syringomyelia and 75 without syringomyelia. Key variables included tonsillar herniation, syrinx length, and surgical outcomes. Statistical analyses were done using t-test and chi-square test to assess relationship between variables, with a significance threshold of p<0.05.

Results: Patients with syringomyelia exhibited significantly higher tonsillar herniation (mean: 10.8 ± 2.3 mm) compared to those without syringomyelia (mean: 7.4 ± 1.9 mm) with p<0.001. Syrinx presence was significantly associated with surgical outcomes (p<0.05). Among patients with syrinx, those with improved surgical outcomes had a mean syrinx length of 18.6 ± 7.5 mm, while stable or unimproved cases exhibited larger syrinx lengths. A significant difference in surgical outcomes was noted between the groups, emphasizing the clinical impact of syrinx presence.

Conclusion: A strong association was found between syrinx presence and clinical outcomes in Arnold-Chiari malformation. Early diagnosis and timely intervention are critical for improved patient outcomes.

Keywords: Arnold-Chiari malformation, Surgical outcomes, Syringomyelia, Tonsillar herniation