ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2021
Long-term outcomes of posterior fossa decompression for Chiari malformation type 1: which patients are most prone to failure?
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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9 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Risk of meningitis after posterior fossa decompression with duraplasty using different graft types in patients with Chiari malformation type I and syringomyelia: a systematic review and meta-analysis.Neurosurgical review · 2022Pooled it
- Duraplasty Versus Bony Decompression in Adult Chiari I: Comparative Clinical and Morphometric Analysis.Medicina (Kaunas, Lithuania) · 2026Article
- Chiari type 1 malformations and hypermobility spectrum disorder: clinical outcomes and the importance of the differential diagnosis.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Can posterior fossa decompression alone effectively treat Chiari malformation type I patients with even severe syringes? Illustrative cases.Journal of neurosurgery. Case lessons · 2025Article
- Duraplasty using a combination of a pedicled dural flap and collagen matrix in posterior fossa decompression for pediatric Chiari malformation type 1 with syrinx.Acta neurochirurgica · 2024Article
- Complication Avoidance in Chiari Malformation Surgery.Advances and technical standards in neurosurgery · 2024Review
- Chiari Type 1 Malformation and Syringomyelia in Children: Classification and Treatment Options.Advances and technical standards in neurosurgery · 2023Review
- Phenotypes and Prognostic Factors of Syringomyelia in Single-Center Patients With Chiari I Malformation: Moniliform Type as a Special Configuration.Neurospine · 2022Article
- A Clinical Study on the Treatment of Recurrent Chiari (Type I) Malformation with Syringomyelia Based on the Dynamics of Cerebrospinal Fluid.BioMed research international · 2022Article
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Authors and funding
8 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe role of an osseous-only posterior fossa decompression (PFD) for Chiari malformation type 1 (CM1) remains controversial. We reviewed long-term outcomes for patients with CM1 undergoing a PFD to evaluate if there was any difference for failure when compared to patients undergoing a PFD with duraplasty (PFDD).
methodsConsecutive patients surgically treated at a single tertiary pediatric neurosurgery clinic over a 25-year period with at least 5 years of follow-up were evaluated. PFD patients were compared to those that initially received a PFDD. Demographics, surgical indications, surgical approach, outcomes, and complications were reviewed.
resultsA total of 60 patients were included in this study of which 25 (41.67%) underwent PFD and 35 (58.33%) underwent PFDD. Mean age at surgery was 7.41 years (range 0.4 to 18 years) with a mean follow-up of 8.23 years (range 5 to 21 years). Those that received a PFD had a lower rate of radiographic syrinx improvement (p = 0.03), especially in the setting of holocord syringes. Failure rate was significantly higher in the PFD group (20% vs 2.90%, p = 0.03). However, complications were significantly higher in the PFDD group (17.14% vs 4.0%, p = 0.04).
conclusionsPFD provides a safe treatment option with similar clinical improvements and lower post-operative complication rate compared to PFDD, albeit at the cost of greater chance of reoperation, especially in the setting of a holocord syrinx. Patients with a holocord syrinx should be considered for a PFDD as their initial procedure.
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