Conditions / Diagnoses
Adult Tethered Cord
Ankylosing Spondylitis
Basilar Invagination
Chiari Malformation
Degenerative Disc Disease (Cervical and Lumbar)
Disc Herniation
Facet Joint Syndrome / Facet Blocks
Fibromyalgia
Myelopathy
Osteomyelitis
Osteoporosis / Vertebral Fractures
Osteoarthritis of the Spine
Osteoarthritis of the Peripheral Joint
Platybasia
Radiculopathy (Cervical and Lumbar)
Rheumatoid Arthritis
Scoliosis
Spinal Compression Fractures
Spinal Cord Injury
Spinal Cord Tumors
Stenosis
Syringomyelia
Trochanteric Bursitis
Chiari Malformation
There are two levels of this anomaly, in which part of the brain protrudes into the spinal
cord.
Chiari I Malformation is relatively simple and is not associated with other congenital
brain malformations. In this condition, peg-like cerebellar tonsils are displaced downward
through the foramen magnum (the opening at the bottom of the skull) into the upper cervical
spinal canal. Chiari II malformation is a complex anomaly with skull, dura, brain, spine,
and spinal cord manifestations, which usually presents in early childhood or in the neonatal
period. This disorder is usually associated with the spinal defect myelomeningocele.
Symptoms: Chiari malformation is characterized by pain, especially headache in the back
of the head, aggravated by coughing and straining. Weakness is also prominent, especially
in the hands. Other symptoms include neck, arm, and leg pain, numbness, loss of temperature
sensation, unsteadiness, double vision, slurred speech, trouble swallowing, vomiting, and
tinnitus (ringing in the ears). In Chiari II malformation, these symptoms are often accompanied
by difficulties swallowing and breathing, especially inhaling.
Diagnosis: MRI is the diagnostic test of choice for Chiari I malformation, since it easily
shows the tonsillar herniation as well as syringomyelia, which occurs in 20-30 percent of
cases.
Treatment: These conditions are surgically treated by removing bone in the region of tonsillar
herniation. Chiari II malformation typically requires inserting a shunt to reduce the herniation.