Letter to the Editor. Reappraisal of nuchal ligament as a dura substitute for Chiari malformation type I

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TO THE EDITOR: We read with interest the article by Cools et al.1 (Cools MJ, Quinsey CS, Elton SW: Chiari decompression outcomes using ligamentum nuchae harvest and duraplasty in pediatric patients with Chiari malformation type I. J Neurosurg Pediatr 22:47–51, July 2018). As the authors note, the choice of material to be used for duraplasty around the herniated tonsil remains a matter of debate. In their study, they re-appraised Kosnik’s method, which is to harvest the nuchal ligament for a patch graft.2 Cools and colleagues reported quite good results for patients with

Article Information

Correspondence Toshikazu Kimura: tkim-tky@umin.ac.jp.

INCLUDE WHEN CITING Published online September 7, 2018; DOI: 10.3171/2018.7.PEDS18403.

Disclosures The authors report no conflict of interest.

© AANS, except where prohibited by US copyright law.

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1

Cools MJQuinsey CSElton SW: Chiari decompression outcomes using ligamentum nuchae harvest and duraplasty in pediatric patients with Chiari malformation type I. J Neurosurg Pediatr 22:47512018

2

Kosnik EJ: Use of ligamentum nuchae graft for dural closure in posterior fossa surgery. Technical note. J Neurosurg 89:1551561998

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