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Evaluation of operative procedures for symptomatic outcome after decompression surgery for Chiari type I malformation.
J Clin Neurosci. 2012 Sep; 19(9):1268-72.JC

Abstract

The wide spectrum of symptoms and radiographic findings in patients with Chiari I malformation makes the decision to proceed with intervention controversial. We evaluated symptomatic outcomes using diverse surgical techniques in 104 patients who underwent decompression surgery. The symptoms of most patients improved. Patients with syringomyelia showed less symptomatic improvement; however, syringomyelia was not associated with postoperative symptomatic worsening. Durotomy was performed in 97.1% and arachnoid opening was performed in 60.6% with visualization of the fourth ventricle in 51.9% of patients. Neither arachnoid opening nor fourth ventricle visualization was associated with the clinical outcome. Duraplasty was performed in 94.2% of patients. A Chiari plate was used in 13.4% of patients and was associated with favorable outcomes. Use of postoperative steroids or muscle relaxants was not associated with outcome. Syringomyelia showed a 62.5% improvement rate on postoperative MRI. In conclusion, bony decompression and dural opening are important aspects of Chiari I surgery, with symptomatic improvement observed in most patients.

Authors+Show Affiliations

Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22771142

Citation

Kalb, Samuel, et al. "Evaluation of Operative Procedures for Symptomatic Outcome After Decompression Surgery for Chiari Type I Malformation." Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, vol. 19, no. 9, 2012, pp. 1268-72.
Kalb S, Perez-Orribo L, Mahan M, et al. Evaluation of operative procedures for symptomatic outcome after decompression surgery for Chiari type I malformation. J Clin Neurosci. 2012;19(9):1268-72.
Kalb, S., Perez-Orribo, L., Mahan, M., Theodore, N., Nakaji, P., & Bristol, R. E. (2012). Evaluation of operative procedures for symptomatic outcome after decompression surgery for Chiari type I malformation. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, 19(9), 1268-72. https://doi.org/10.1016/j.jocn.2012.01.025
Kalb S, et al. Evaluation of Operative Procedures for Symptomatic Outcome After Decompression Surgery for Chiari Type I Malformation. J Clin Neurosci. 2012;19(9):1268-72. PubMed PMID: 22771142.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of operative procedures for symptomatic outcome after decompression surgery for Chiari type I malformation. AU - Kalb,Samuel, AU - Perez-Orribo,Luis, AU - Mahan,Mark, AU - Theodore,Nicholas, AU - Nakaji,Peter, AU - Bristol,Ruth E, Y1 - 2012/07/05/ PY - 2011/07/28/received PY - 2012/01/19/revised PY - 2012/01/21/accepted PY - 2012/7/10/entrez PY - 2012/7/10/pubmed PY - 2012/12/28/medline SP - 1268 EP - 72 JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia JO - J Clin Neurosci VL - 19 IS - 9 N2 - The wide spectrum of symptoms and radiographic findings in patients with Chiari I malformation makes the decision to proceed with intervention controversial. We evaluated symptomatic outcomes using diverse surgical techniques in 104 patients who underwent decompression surgery. The symptoms of most patients improved. Patients with syringomyelia showed less symptomatic improvement; however, syringomyelia was not associated with postoperative symptomatic worsening. Durotomy was performed in 97.1% and arachnoid opening was performed in 60.6% with visualization of the fourth ventricle in 51.9% of patients. Neither arachnoid opening nor fourth ventricle visualization was associated with the clinical outcome. Duraplasty was performed in 94.2% of patients. A Chiari plate was used in 13.4% of patients and was associated with favorable outcomes. Use of postoperative steroids or muscle relaxants was not associated with outcome. Syringomyelia showed a 62.5% improvement rate on postoperative MRI. In conclusion, bony decompression and dural opening are important aspects of Chiari I surgery, with symptomatic improvement observed in most patients. SN - 1532-2653 UR - https://www.unboundmedicine.com/medline/citation/22771142/Evaluation_of_operative_procedures_for_symptomatic_outcome_after_decompression_surgery_for_Chiari_type_I_malformation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0967-5868(12)00113-0 DB - PRIME DP - Unbound Medicine ER -