Evidence map›Paper›PMID 37109355›Full record

ArticleJournal of clinical medicine2023

Syringomyelia Associated with Chiari 1 Malformation in Adults: Positive Outcome Predictors after Posterior Fossa Decompression with Duraplasty.

Palma Ciaramitaro, Giuseppe Migliaretti, Marilena Ferraris, Andrea Garnero, Giovanni Morana, Paolo Carucci, Ilaria Stura, Fulvio Massaro, Diego Garbossa

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.3field-weighted citation impact, top 12% 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

7 citing papers in PubMed, 8 citations in OpenAlex.

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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

9 authors at 2 institutions in 1 country.

Palma CiaramitaroNeuroscience Department, University of Torino, 10126 Torino, Italy.ORCID 0000-0002-7345-8691
Giuseppe MigliarettiDepartment of Public Health and Paediatric Sciences, University of Torino, 10126 Torino, Italy.
Marilena FerrarisDiagnostic Imaging Department, AOU Citta' della Salute e della Scienza di Torino, 10126 Torino, Italy.
Andrea GarneroDiagnostic Imaging Department, AOU Citta' della Salute e della Scienza di Torino, 10126 Torino, Italy.
Giovanni MoranaNeuroscience Department, University of Torino, 10126 Torino, Italy.
Paolo CarucciNeuroscience Department, University of Torino, 10126 Torino, Italy.
Ilaria SturaNeuroscience Department, University of Torino, 10126 Torino, Italy.ORCID 0000-0001-9815-5446
Fulvio MassaroNeuroscience Department, University of Torino, 10126 Torino, Italy.
Diego GarbossaNeuroscience Department, University of Torino, 10126 Torino, Italy.ORCID 0000-0002-2692-7133
Azienda Ospedaliera Citta' della Salute e della Scienza di Torino · ITUniversity of Turin · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSyringomyelia (Syr) in patients with Chiari 1 malformation (CM1) may be attributable to abnormal dynamics of cerebrospinal fluid (CSF) in the upper cervical segment; fourth ventricle enlargement has been reported in association with a worse clinical and radiological presentation, independently of the posterior fossa volume. In this study, we analyzed presurgery hydrodynamic markers to evaluate if their changes could be associated with clinical and radiological improvement after posterior fossa decompression and duraplasty (PFDD). As a primary endpoint, we aimed to correlate improvement in the fourth ventricle area with positive clinical outcomes.

methodsIn total, in this study, we enrolled 36 consecutive adults with Syr and CM1 who were followed by a multidisciplinary team. All the patients were prospectively evaluated with clinical scales and neuroimaging, including CSF flow, the fourth ventricle area, and the Vaquero Index by using a phase-contrast MRI before (T0) and after surgical treatment (T1-Tlast, with a range of 12-108 months). The CSF flow at the craniocervical junction (CCJ), the fourth ventricle area, and the Vaquero Index changes were statistically analyzed and compared to the clinical and quality of life improvement after surgery. The good outcome prediction ability of presurgical radiological variables was tested.

resultsSurgery was associated with positive clinical and radiological outcomes in more than 90% of cases. The fourth ventricle area significantly reduced after surgery (T0-Tlast,

conclusionsPresurgery CSF flow at the CCJ is proposed as a radiological marker with the ability to predict a positive outcome after PFDD in adults with syringomyelia and CM1. Measurements of the fourth ventricle area could be useful additional information for evaluating surgical long-term follow-up; further experience on larger cohorts is required to better define the prognostic yield of this radiological parameter.

Indexed as

adultsChiari 1 malformationoutcomePC-MRIPFDDsurgerysyringomyelia

Identifiers

PMID37109355
PMCPMC10143011
OpenAlexW4366774501

What OpenQuestion holds

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Registered trials

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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.