1. Endoscopic foramen Magnum decompression in Chiari 1 malformation with or without syringomyelia
Y R Yadav, Vijay Parihar, Shailendra Ratre, Amitesh Dubey, Pankaj Kumar
Department of Neurosurgery
NSCB (Government) Medical College Jabalpur MP India
Recipient of Charak award (IMA MP state 2011)
Chairman fellowship program of one week brain and spine endoscopic training
Executive member of Neurological surgeons society of India
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2. Announcement
We are starting 11 months university certified Neuroendoscopy course Last date of application is 15 Feb

3. Endoscopic foramen Magnum decompression in Chiari 1 malformation with or without syringomyelia
Introduction:
Foramen magnum decompression has been found to be safe and effective treatment in ACM without basilar invasion.
Posterior fossa decompression has been described using endoscopic techniques in 2001 by Teo C et al
(Mobbs R, Teo C.Endoscopic assisted posterior fossa decompression. J Clin Neurosci Jul;8(4): )

4. Indications: In ACM and ACM with syrings
(Di X. Endoscopic suboccipital decompression on pediatric Chiari type I. Minim Invasive Neurosurg Jun;52(3): doi: /s Epub 2009 Jul 31.
Deng K, Li YN, Li GL, Gao J, Yang Z, Di X, Wang RZ. Neural endoscopic assisted micro-invasive management of Chiari I malformation. Chin Med J (Engl) Jul;123(14): 

Gao J, Yang Z, Li YN, Wang RZ. [The preliminary study of using neuro-endoscope assisted atlanto occipital decompression to treat Chiari type I malformation with syringomyelia]. Zhonghua Wai Ke Za Zhi Oct 1;48(19): )

5. Endoscopic foramen Magnum decompression in Chiari 1 malformation with or without syringomyelia
Advantages:
Minimal invasive nature,
Fewer complications,
Decreased chances of instability of bony structure,
Faster recovery,
Reduced hospital stay,
Less expenses,
Safe and effective surgical procedure

6. Showing pre and post op images

7. Showing bony decompression

8. Reconstructed image of bony decompression

9. Showing various steps of surgery

10. Showing partially split dura

11. Endoscopic foramen Magnum decompression in Chiari 1 malformation with or without syringomyelia
Technique:
Supine position
Neck flexed
Upper neck and sub-occipital area should be flat.
cm incision.

12. Endoscopic foramen Magnum decompression with C1 laminectomy in Chiari 1 malformation with or without syringomyelia
Technique:
Avoid C2 spine and lamina removal, Upper part of C2 may have to be drilled to position endoscopic set.
Mid line marked by drilling at foramen Magnum and at C1
About 1 cm on either side is drilled at C1
About 2 cm decompression is done at foramen magnum.

13. Endoscopic foramen Magnum decompression with C1 laminectomy in Chiari 1 malformation with or without syringomyelia
Technique:
Atlanto occipital fascia is removed
Outer layer of dura is split opened
Any dural tear is repaired by tissue glue

14. References: Ratre S, Yadav N, Yadav YR, Parihar V, Bajaj J, Kher Y
References: Ratre S, Yadav N, Yadav YR, Parihar V, Bajaj J, Kher Y. Endoscopic management of Arnold Chiari Malformation type 1 with or without syringomyelia. J Neurol Surg A Cent Eur Neurosurg in press.

15. Thankful to my teachers

16. Thankful To My
colleagues