Developments in the treatment of Chiari type 1 malformations over the past decade
| Autor: | John Y. Moon, Frank A. Segreto, Peter L. Zhou, Bassel G. Diebo, Gregory W. Poorman, Akhila Sure, Matthew Y. Siow, Muhammad B. Janjua, Nicholas J. Frangella, Cole Bortz, Alexandra Pyne, Peter G. Passias, Dennis Vasquez-Montes, Shaleen Vira, Samantha R. Horn |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Pediatrics
medicine.medical_specialty business.industry Incidence (epidemiology) Scoliosis medicine.disease Dysphagia Hydrocephalus 03 medical and health sciences 0302 clinical medicine Syringobulbia 030220 oncology & carcinogenesis Spinal decompression Medicine Orthopedics and Sports Medicine Surgery Original Study medicine.symptom business Complication 030217 neurology & neurosurgery Syringomyelia |
| Zdroj: | Journal of spine surgery (Hong Kong). 4(1) |
| ISSN: | 2414-469X |
| Popis: | Background: Chiari malformations type 1 (CM-1), a developmental anomaly of the posterior fossa, usually presents in adolescence or early adulthood. There are few studies on the national incidence of CM-1, taking into account outcomes based on concurrent diagnoses. To quantify trends in CM-1 treatment and associated diagnoses. Retrospective review of the Kids’ Inpatient Database (KID) from 2003–2012. Methods: Patients, aged 0–20, with primary diagnosis of CM-1 in the KID database were identified. Demographics and concurrent diagnoses were analyzed using chi-squared and t-tests for categorical and numerical variables, respectively. Trends in diagnosis, treatments, and outcomes were analyzed using analysis of variance (ANOVA). Results: Five thousand four hundred and thirty-eight patients were identified in the KID database with primary diagnosis of CM-1 (10.5 years, 55% female). CM-1 primary diagnoses have increased over time (45 to 96 per 100,000). CM-1 patients had the following concurrent diagnoses: 23.8% syringomyelia/syringobulbia, 11.5% scoliosis, 5.9% hydrocephalus, 2.2% tethered cord syndrome. Eighty-three point four percent of CM-1 patients underwent surgical treatment, and rate of surgical treatment for CM-1 increased from 2003–2012 (66% to 72%, P vs . 4.7%). Seven point four percent of patients experienced at least one peri-operative complication (nervous system, dysphagia, respiratory most common). Patients with concurrent hydrocephalus had increased nervous and respiratory systems, urinary, and respiratory complications (P Conclusions: CM-1 malformation diagnoses have increased in the last decade. Despite the decrease in overall complication rates, fusions are becoming more common and are associated with higher peri-operative complication rates. Commonly associated diagnoses including syringomyelia and hydrocephalus, can dramatically increase experienced complication rates. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|