Evidence map›Paper›PMID 33471302›Full record

ArticleSpine deformity2021

Scoliosis with Chiari I malformation without associated syringomyelia.

Nora P O'Neill, Patricia E Miller, Michael T Hresko, John B Emans, Lawrence I Karlin, Daniel J Hedequist, Brian D Snyder, Edward R Smith, Mark R Proctor, Michael P Glotzbecker

Abstract read
PubMed Publisher
In one paragraph

Article in Spine deformity, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 22% of its field
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. 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

10 authors at 1 institution in 1 country.

Nora P O'NeillDepartment of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA.ORCID 0000-0001-9263-0373
Patricia E MillerDepartment of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA.
Michael T HreskoDepartment of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA.
John B EmansDepartment of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA.
Lawrence I KarlinDepartment of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA.
Daniel J HedequistDepartment of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA.
Brian D SnyderDepartment of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA.
Edward R SmithDepartment of Neurosurgery, Boston Children's Hospital, Boston, MA, USA.
Mark R ProctorDepartment of Neurosurgery, Boston Children's Hospital, Boston, MA, USA.
Michael P GlotzbeckerDepartment of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA. michael.glotzbecker@UHhospitals.org.
Boston Children's Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMany patients with presumed idiopathic scoliosis are found to have Chiari I malformation (CM-I) on MRI. The objective of this study is to report on scoliosis progression in CM-I with no syringomyelia.

methodsA retrospective review of patients with scoliosis and CM-I was conducted from 1997 to 2015. Patients with syringomyelia and/or non-idiopathic scoliosis were excluded. Clinical and radiographic characteristics were recorded at presentation and latest follow-up. CM-I was defined as the cerebellar tonsil extending 5 mm or more below the foramen magnum on MRI.

resultsThirty-two patients (72% female) with a mean age of 11 years (range 1-16) at scoliosis diagnosis were included. The average initial curve was 30.3° ± SD 16.3. The mean initial Chiari size was 9.6 mm SD ± 4.0. Fifteen (46.9%) experienced Chiari-related symptoms, and three (9%) patients underwent Posterior Fossa Decompression (PFD) to treat these symptoms. 10 (31%) patients went on to fusion, progressing on average 13.6° (95% CI 1.6-25.6°). No association was detected between decompression and either curve progression or fusion (p = 0.46, 0.60). For those who did not undergo fusion, curve magnitude progressed on average 1.0° (95% CI - 4.0 to 5.9°). There was no association between age, Chiari size, presence of symptoms, initial curve shape, or bracing treatment and fusion.

conclusionPatients with CM-I and scoliosis may not require surgical treatment, including PFD and fusion. Scoliosis curvature stabilized in the non-surgical population at an average progression of 1.0°. These results suggest that CM-I with no syringomyelia has minimal effect on scoliosis progression.

Indexed as

Arnold-Chiari MalformationScoliosisSyringomyeliaAdolescentChildChild, PreschoolFemaleHumansInfantMaleRetrospective StudiesTreatment OutcomeChiari I MalformationIdiopathic ScoliosisPosterior Fossa DecompressionPosterior Spinal Fusion

Identifiers

PMID33471302
OpenAlexW3125859123

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.