High long-term symptomatic recurrence rates after Chiari-1 decompression without dural opening: a single center experience
| Autor: | Libby Kosnik-Infinger, Marc McLawhorn, Vibhor Krishna, Sunil J. Patel |
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| Rok vydání: | 2013 |
| Předmět: |
musculoskeletal diseases
Adult Male medicine.medical_specialty Adolescent Decompression Radiography Dura mater Single Center Neurosurgical Procedures Young Adult Recurrence Risk Factors medicine Humans Chiari malformation Aged Neurologic Examination business.industry General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Arnold-Chiari Malformation medicine.anatomical_structure Treatment Outcome Improvement rate Data Interpretation Statistical Female Neurology (clinical) Dura Mater business Complication Syringomyelia Follow-Up Studies |
| Zdroj: | Clinical neurology and neurosurgery. 118 |
| ISSN: | 1872-6968 |
| Popis: | Objective We evaluated long-term outcomes of posterior fossa decompression (PFD) without duroplasty in consecutive patients with newly diagnosed Chiari-1 malformation. Methods We searched the institutional database for all adult patients who underwent Chiari decompression between 1995 and 2007. PFD was offered to all consecutive patients with Chairi-1 malformation during this time period. We excluded patients who underwent re-exploration after initial Chiari-1 decompression elsewhere. Besides the demographic variables, presenting symptoms, neurological and radiographic findings the clinical records were studied for long-term outcomes specifically symptomatic improvement. We defined symptomatic improvement as resolution of all presenting symptoms including pain and/or neurological deficits at the last follow-up. The factors associated with symptom recurrence were also analyzed. Results We identified 47 patients who underwent PFD for Chiari-1 malformation. Syringomyelia was noted in 36.2% of patients and the mean tonsilar herniation was 12.6 mm. At a mean follow-up of 9.3 years, the symptomatic improvement rate was 60.6%. There were no operative complications. Repeat posterior fossa decompression was required for 31.9% patients with symptomatic recurrence at an average of 2.6 years after initial decompression. Fibrotic thickening overlying the dura mater was observed in one-third of these patients. Conclusions This case series reports low complication but high long-term symptomatic recurrence rates adults with symptomatic Chiari-1 malformation undergoing PFD. |
| Databáze: | OpenAIRE |
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