Evaluating CSF Flow (Cine MR) and Clinical Outcomes in Patients with Chiari Type 1 Who Underwent Dural Relaxation or Durotomy

Background: Cine magnetic resonance imaging (MRI) is increasingly used to evaluate abnormalities in the cerebrospinal fluid (CSF) flow in Chiari Malformation Type I (CM-I). However, its role in postoperative follow-up remains unclear. Methods: A retrospective analysis was performed on 58 CM-I patients who underwent foramen magnum decompression using dural relaxation or durotomy techniques. CSF flow velocities, measured using Cine MRI, were evaluated preoperatively and at one and six months postoperatively. Results: Postoperative CSF flow velocities were significantly increased in both follow-up periods compared to preoperative measurements (p < 0.001). The CSF flow velocity at six months postoperatively was also significantly higher than at one month postoperatively (p < 0.001). In patients with increased cerebrospinal fluid flow, the main VAS (Visual Analog Scale) score decreased and the SF-36 score increased, while growth was observed in areas where postoperative changes decreased, and these areas required reoperation. Conclusions: Dural relaxation or durotomy with foramen magnum decompression effectively improves CSF flow dynamics in CM-I patients. Cine MRI can provide valuable information regarding surgical adequacy and postoperative follow-up.