Evidence map›Paper›PMID 31127343›Full record

Observational studyChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2019

Outcomes and complications for individual neurosurgeons for the treatment of Chiari I malformation at a children's hospital.

Tasha-Kay Walker-Palmer, D Douglas Cochrane, Ashutosh Singhal, Paul Steinbok

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. The management of Chiari malformation type 1 and syringomyelia in children: a review of the literature.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021
    Pooled it
  2. Article
  3. Reoperation in Chiari-1 Malformations.Journal of clinical medicine · 2023
    Article
  4. Article
  5. Long-term outcomes of posterior fossa decompression for Chiari malformation type 1: which patients are most prone to failure?Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Tasha-Kay Walker-PalmerDivision of Neurosurgery, British Columbia Children's Hospital, 4480 Oak Street, Rm K3-159, Vancouver, BC, V6H 3V4, Canada. tkkwalker@gmail.com.ORCID 0000-0003-3015-0926
D Douglas CochraneDivision of Neurosurgery, British Columbia Children's Hospital, 4480 Oak Street, Rm K3-159, Vancouver, BC, V6H 3V4, Canada.
Ashutosh SinghalDivision of Neurosurgery, British Columbia Children's Hospital, 4480 Oak Street, Rm K3-159, Vancouver, BC, V6H 3V4, Canada.
Paul SteinbokDivision of Neurosurgery, British Columbia Children's Hospital, 4480 Oak Street, Rm K3-159, Vancouver, BC, V6H 3V4, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this study was to evaluate the outcomes and complications for individual surgeons at British Columbia Children's Hospital for the treatment of Chiari I Malformation (CMI) in children.

methodsThis was a retrospective review of patients with CMI who had surgery from 1986 to 2015. We assessed the Chicago Chiari Outcome Scores (CCOS) and complication rates by surgeon.

resultsSeventy patients, 38 males and 32 females, underwent posterior fossa decompression including 14 extradural and 56 intradural approaches. Syringomyelia was present in 74.3%. Most syringomyelia improved with no difference between intradural and extradural surgeries. After initial surgery, 13 patients (18.6%) had complications including 2/14 (14.3%) of extradural and 11/56 (19.6%) of intradural surgeries. Two patients required surgical intervention for complications whereas 11 had transient complications. The complication rate by surgeon ranged from 11 to 20% for extradural (2 surgeons only) and 10.5 to 40% for intradural surgeries (4 surgeons). The CCOS ranged from 12 to 15 for extradural and 6 to 16 for intradural. The CCOS ranges for surgeons 1 and 2 were 12-15 and 13-15 respectively for extradural. The CCOS ranges for surgeons 1, 2, 3, and 4 were 12-16, 6-15, 12-16, and 12-16 respectively for intradural. Thirteen patients had a second surgery for CMI. The final CCOS was good in 86% and moderate in 14%.

conclusionThere was variability in surgeries performed at BCCH by different surgeons, with variations in CCOS and complication rates. This information is important during decision making, consent process, and for quality improvement.

Indexed as

Postoperative ComplicationsAdolescentArnold-Chiari MalformationBritish ColumbiaChildChild, PreschoolFemaleFollow-Up StudiesHospitals, PediatricHumansMaleNeurosurgeonsNeurosurgical ProceduresRetrospective StudiesSyringomyeliaTreatment OutcomeChiari I malformationComplicationsOutcomesPediatricPosterior fossa decompressionSyringomyelia

Identifiers

PMID31127343

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.