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[Comparison of posterior fossa decompression with and without duraplasty for surgical management for adult Chiari malformation type Ⅰ].
Zhonghua Yi Xue Za Zhi. 2017 Jul 04; 97(25):1947-1950.ZY

Abstract

Objective:

To evaluate and compare the efficacy between posterior fossa decompression without duraplasty (PFD) and posterior fossa decompression with duraplasty (PFDD) in the surgical management for adult Chiari Ⅰ malformation.

Methods:

Fifty-seven patients suffered from Chiari malformation type Ⅰ were treated in Department of Neurosurgery, Henan Provincial People's Hospital from August 2008 to October 2013. Twenty-three patients received posterior fossa decompression without duraplasty and the other 34 patients received posterior fossa decompression with duraplasty. The clinical results were retrospectively analyzed to compare the efficacy of two different surgical approaches.

Results:

There was no death or severe neurological dysfunction case in 57 patients of the two groups. Patients undergoing PFD had shorter length of hospital stay[(13.7±3.5) d vs (16.2±4.1) d, P<0.05]and surgical time[(98.7±22.1) min vs (132.3±39.6)min, P<0.05]. Cerebrospinal fluid-related complications and intracranial infection were more common in patients undergoing PFDD[(0/23, 0) vs (8/34, 23.5%), P<0.05]. Clinical improvement was comparable in two groups[(15/23, 65.2%) vs (26/34, 76.5%), P>0.05]at the one-year follow-up. The rate of syrinx regression in patients with Syringomyelia was higher in patients undergoing PFDD[(3/12, 25%) vs (17/22, 77.3%), P<0.05].

Conclusion:

For adult patients with Chiari malformation type Ⅰ, PFD has the advantages of simple manipulation, short length of hospital stay and low incidence of cerebrospinal fluid-related complications and intracranial infection, compared with PFDD. It is comparable to PFDD in clinical improvement, but the effect of PFD is not as good as that of PFDD in the aspect of syrinx regression.

Authors+Show Affiliations

Department of Neurosurgery, Henan Provincial People's Hospital, Zhengzhou 450003, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

chi

PubMed ID

28693072

Citation

Li, H Y., et al. "[Comparison of Posterior Fossa Decompression With and Without Duraplasty for Surgical Management for Adult Chiari Malformation Type Ⅰ]." Zhonghua Yi Xue Za Zhi, vol. 97, no. 25, 2017, pp. 1947-1950.
Li HY, Li YM, Chen H, et al. [Comparison of posterior fossa decompression with and without duraplasty for surgical management for adult Chiari malformation type Ⅰ]. Zhonghua Yi Xue Za Zhi. 2017;97(25):1947-1950.
Li, H. Y., Li, Y. M., Chen, H., Li, Y., & Shi, X. W. (2017). [Comparison of posterior fossa decompression with and without duraplasty for surgical management for adult Chiari malformation type Ⅰ]. Zhonghua Yi Xue Za Zhi, 97(25), 1947-1950. https://doi.org/10.3760/cma.j.issn.0376-2491.2017.25.006
Li HY, et al. [Comparison of Posterior Fossa Decompression With and Without Duraplasty for Surgical Management for Adult Chiari Malformation Type Ⅰ]. Zhonghua Yi Xue Za Zhi. 2017 Jul 4;97(25):1947-1950. PubMed PMID: 28693072.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Comparison of posterior fossa decompression with and without duraplasty for surgical management for adult Chiari malformation type Ⅰ]. AU - Li,H Y, AU - Li,Y M, AU - Chen,H, AU - Li,Y, AU - Shi,X W, PY - 2017/7/11/entrez PY - 2017/7/12/pubmed PY - 2018/6/26/medline KW - Arnold-Chiari malformation KW - Microsurgery KW - Syringomyelia SP - 1947 EP - 1950 JF - Zhonghua yi xue za zhi JO - Zhonghua Yi Xue Za Zhi VL - 97 IS - 25 N2 - Objective: To evaluate and compare the efficacy between posterior fossa decompression without duraplasty (PFD) and posterior fossa decompression with duraplasty (PFDD) in the surgical management for adult Chiari Ⅰ malformation. Methods: Fifty-seven patients suffered from Chiari malformation type Ⅰ were treated in Department of Neurosurgery, Henan Provincial People's Hospital from August 2008 to October 2013. Twenty-three patients received posterior fossa decompression without duraplasty and the other 34 patients received posterior fossa decompression with duraplasty. The clinical results were retrospectively analyzed to compare the efficacy of two different surgical approaches. Results: There was no death or severe neurological dysfunction case in 57 patients of the two groups. Patients undergoing PFD had shorter length of hospital stay[(13.7±3.5) d vs (16.2±4.1) d, P<0.05]and surgical time[(98.7±22.1) min vs (132.3±39.6)min, P<0.05]. Cerebrospinal fluid-related complications and intracranial infection were more common in patients undergoing PFDD[(0/23, 0) vs (8/34, 23.5%), P<0.05]. Clinical improvement was comparable in two groups[(15/23, 65.2%) vs (26/34, 76.5%), P>0.05]at the one-year follow-up. The rate of syrinx regression in patients with Syringomyelia was higher in patients undergoing PFDD[(3/12, 25%) vs (17/22, 77.3%), P<0.05]. Conclusion: For adult patients with Chiari malformation type Ⅰ, PFD has the advantages of simple manipulation, short length of hospital stay and low incidence of cerebrospinal fluid-related complications and intracranial infection, compared with PFDD. It is comparable to PFDD in clinical improvement, but the effect of PFD is not as good as that of PFDD in the aspect of syrinx regression. SN - 0376-2491 UR - https://www.unboundmedicine.com/medline/citation/28693072/[Comparison_of_posterior_fossa_decompression_with_and_without_duraplasty_for_surgical_management_for_adult_Chiari_malformation_type_Ⅰ]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=0376-2491&amp;year=2017&amp;vol=97&amp;issue=25&amp;fpage=1947 DB - PRIME DP - Unbound Medicine ER -