Evidence map›Paper›PMID 38227601›Full record

ArticlePloS one2024

Morphological and ultrastructural investigation of the posterior atlanto-occipital membrane: Comparing children with Chiari malformation type I and controls.

Vijay M Ravindra, Lorraina Robinson, Hailey Jensen, Elena Kurudza, Evan Joyce, Allison Ludwick, Russell Telford, Osama Youssef, Justin Ryan, Robert J Bollo and 6 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

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

16 authors at 5 institutions in 1 country.

Vijay M RavindraDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States of America.ORCID 0000-0002-4496-7622
Lorraina RobinsonDepartment of Pathology, University of Utah, Salt Lake City, Utah, United States of America.ORCID 0009-0005-1098-4909
Hailey JensenDepartment of Pediatrics, University of Utah, Data Coordinating Center, Salt Lake City, Utah, United States of America.
Elena KurudzaDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States of America.
Evan JoyceDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States of America.
Allison LudwickDivision of Pediatric Neurosurgery, Primary Children's Hospital, Salt Lake City, Utah, United States of America.
Russell TelfordDepartment of Pediatrics, University of Utah, Data Coordinating Center, Salt Lake City, Utah, United States of America.
Osama YoussefHuntsman Cancer Institute, Salt Lake City, Utah, United States of America.ORCID 0000-0002-9951-5324
Justin RyanDepartment of Neurosurgery, University of California San Diego, San Diego, California, United States of America.ORCID 0000-0002-5432-1817
Robert J BolloDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States of America.
Rajiv R IyerDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States of America.
John R W KestleDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States of America.
Samuel H CheshierDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States of America.
Daniel S IkedaWalter Reed National Military Medical Center, Bethesda, Maryland, United States of America.
Qinwen MaoDepartment of Pathology, University of Utah, Salt Lake City, Utah, United States of America.
Douglas L BrockmeyerDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States of America.
Primary Children's Hospital · USUniversity of Utah · USHuntsman Cancer Institute · USUniversity of California San Diego · USWalter Reed National Military Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe fibrous posterior atlanto-occipital membrane (PAOM) at the craniocervical junction is typically removed during decompression surgery for Chiari malformation type I (CM-I); however, its importance and ultrastructural architecture have not been investigated in children. We hypothesized that there are structural differences in the PAOM of patients with CM-I and those without.

methodsIn this prospective study, blinded pathological analysis was performed on PAOM specimens from children who had surgery for CM-I and children who had surgery for posterior fossa tumors (controls). Clinical and radiographic data were collected. Statistical analysis included comparisons between the CM-I and control cohorts and correlations with imaging measures.

resultsA total of 35 children (mean age at surgery 10.7 years; 94.3% white) with viable specimens for evaluation were enrolled: 24 with CM-I and 11 controls. There were no statistical demographic differences between the two cohorts. Four children had a family history of CM-I and five had a syndromic condition. The cohorts had similar measurements of tonsillar descent, syringomyelia, basion to C2, and condylar-to-C2 vertical axis (all p>0.05). The clival-axial angle was lower in patients with CM-I (138.1 vs. 149.3 degrees, p = 0.016). Morphologically, the PAOM demonstrated statistically higher proportions of disorganized architecture in patients with CM-I (75.0% vs. 36.4%, p = 0.012). There were no differences in PAOM fat, elastin, or collagen percentages overall and no differences in imaging or ultrastructural findings between male and female patients. Posterior fossa volume was lower in children with CM-I (163,234 mm3 vs. 218,305 mm3, p<0.001), a difference that persisted after normalizing for patient height (129.9 vs. 160.9, p = 0.028).

conclusionsIn patients with CM-I, the PAOM demonstrates disorganized architecture compared with that of control patients. This likely represents an anatomic adaptation in the presence of CM-I rather than a pathologic contribution.

Indexed as

Arnold-Chiari MalformationSyringomyeliaChildCranial Fossa, PosteriorDecompression, SurgicalFemaleHumansMagnetic Resonance ImagingMaleProspective Studies

Identifiers

PMID38227601
PMCPMC10791003
OpenAlexW4390905628

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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.