Comparison of Clinical and Radiologic Outcomes between Dural Splitting and Duraplasty for Adult Patients with Chiari Type I Malformation.
Journal
Journal of neurological surgery. Part A, Central European neurosurgery
ISSN: 2193-6323
Titre abrégé: J Neurol Surg A Cent Eur Neurosurg
Pays: Germany
ID NLM: 101580767
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
medline:
31
5
2023
pubmed:
16
6
2022
entrez:
15
6
2022
Statut:
ppublish
Résumé
The most used surgical procedure in the treatment of patients with Chiari type I malformation (CIM) is posterior fossa decompression. However, no consensus has been reached regarding the superiority of either dural splitting or duraplasty. Thus, the aim of this study was to compare clinical and radiologic outcomes between the two techniques used in consecutive patients. We retrospectively reviewed 74 adult patients with CIM who were diagnosed and treated surgically between 2015 and 2020 at our neurosurgery department. The patients were divided into two groups: dural splitting in group 1 and duraplasty in group 2. Clinical outcomes based on Chicago Chiari Outcome Scale (CCOS) scores at the last control visits were compared between the groups. Radiologic outcomes were compared in terms of tonsillar regression rate based on 12-postoperative-month magnetic resonance images. Overall improved, unchanged, and worsened neurologic statuses were observed in 75.6% ( Adult patients undergoing duraplasty had better clinical and radiologic outcomes than those treated with dural splitting. Therefore, we recommend decompression with duraplasty for adult CIM patients.
Sections du résumé
BACKGROUND
BACKGROUND
The most used surgical procedure in the treatment of patients with Chiari type I malformation (CIM) is posterior fossa decompression. However, no consensus has been reached regarding the superiority of either dural splitting or duraplasty. Thus, the aim of this study was to compare clinical and radiologic outcomes between the two techniques used in consecutive patients.
METHODS
METHODS
We retrospectively reviewed 74 adult patients with CIM who were diagnosed and treated surgically between 2015 and 2020 at our neurosurgery department. The patients were divided into two groups: dural splitting in group 1 and duraplasty in group 2. Clinical outcomes based on Chicago Chiari Outcome Scale (CCOS) scores at the last control visits were compared between the groups. Radiologic outcomes were compared in terms of tonsillar regression rate based on 12-postoperative-month magnetic resonance images.
RESULTS
RESULTS
Overall improved, unchanged, and worsened neurologic statuses were observed in 75.6% (
CONCLUSION
CONCLUSIONS
Adult patients undergoing duraplasty had better clinical and radiologic outcomes than those treated with dural splitting. Therefore, we recommend decompression with duraplasty for adult CIM patients.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
370-376Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
None declared.