TY - JOUR T1 - Comparison of surgical outcomes in patients with Chiari Type I malformation receiving posterior fossa decompression with and without duraplasty. AU - Butensky,Samuel, AU - Rodgers,Shaun, AU - Baron,Shanna, AU - Schneider,Steven, AU - Mittler,Mark, Y1 - 2020/05/25/ PY - 2019/11/21/received PY - 2020/05/06/accepted PY - 2020/5/27/pubmed PY - 2021/6/22/medline PY - 2020/5/27/entrez KW - Chiari KW - Duraplasty KW - Extradural KW - Intradural KW - Syringomyelia KW - Syrinx SP - 1399 EP - 1405 JF - Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery JO - Childs Nerv Syst VL - 36 IS - 7 N2 - PURPOSE: The goals of this study were to compare clinical outcomes in patients with Chiari Malformation Type I (CMI) receiving posterior fossa decompression with (PFDD) or without duraplasty (PFD). METHODS: We conducted a retrospective analysis of 178 consecutive cases of 157 patients undergoing PFDD or PFD for CMI at Cohen Children's Medical Center between 2007 and 2017. Clinical improvement was defined as a clear reduction of preoperative symptoms after surgery as reported by patients and parents. An improvement of syrinx was derived from radiologic comparison of pre- and postoperative MR imaging. Chi-square analysis was performed to analyze the association between duraplasty and clinical parameters (alpha = 0.05). RESULTS: The primary presenting complaint was headache (142/178; 80%), followed by neck, back, and upper extremity pain, and numbness or tingling (49/178; 28%). Seventy patients (78/178; 44%) underwent PFD, and 100 patients (100/178; 56%) underwent PFDD. Overall, 143 patients (143/178; 80%) experienced subjective improvement with no statistically significant difference between the two surgical techniques (p = 0.705). The number of patients receiving PFDD with syrinx improvement or stabilization (55/59; 93%) was statistically larger than those that received PFD (8/13; 62%) (p = 0.008). PFDD was associated with greater complications than PFD alone. There were 35 cases of reoperation overall (35/178; 19%), and there was no statistically significant difference in reoperation rate between PFD and PFDD (p = 0.255). CONCLUSIONS: There appears to be a role for PFDD in patients with severe syringomyelia, but overall, PFD alone may be safely offered as the initial surgical intervention for symptomatic CMI patients. SN - 1433-0350 UR - https://www.unboundmedicine.com/medline/citation/32451665/Comparison_of_surgical_outcomes_in_patients_with_Chiari_Type_I_malformation_receiving_posterior_fossa_decompression_with_and_without_duraplasty_ DB - PRIME DP - Unbound Medicine ER -