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BackgroundThe best surgical treatment of Chiari malformation patients with syringomyelia remains controversial, and whether cerebellar tonsillectomy should be performed has not been decided.ObjectiveTo evaluate the efficacy of posterior fossa decompression with duraplasty (PFDD) and Posterior fossa decompression with resection of tonsils (PFDRT) in patients of Chiari malformation type I (CM-I) with syringomyelia and explore relevant factors affecting prognosis.Patients and methodsWe retrospectively analyzed 182 adult patients of CM-I with syringomyelia who underwent PFDD or PFDRT over a 6-year period, and analyzed their clinical manifestations, imaging features, and follow-up data. Clinical outcomes were assessed using the Chicago Chiari Outcome Scale (CCOS), and imaging outcomes were assessed using the syrinx remission rate. Difference comparisons were performed to compare the differences between different surgical groups. Influencing factors associated with outcome were investigated using bivariate analysis and multiple linear regression analysis.ResultsThere were statistically significant differences in CCOS score (p = 0.034) and syrinx remission rates (p = 0.046) between the PFDRT group and the PFDD group after surgery. Regression analysis showed that preoperative motor dysfunction, cerebellar-related symptoms and different surgical methods may have influenced the CCOS score and that brainstem-related symptoms and age may have influenced the syrinx remission rates in the total patient group (p < 0.05). Regression analysis showed that the duration of symptoms, cerebellar-related symptoms and preoperative syrinx diameter may have influenced the CCOS score and that the preoperative cerebellar tonsillar hernia distance may have influenced the postoperative syrinx remission rate in the PFDRT group (p < 0.05). Age and length of hospital stay may have influenced the CCOS score, and brainstem-related symptoms and age may have influenced the syrinx remission rates in the PFDD group (p < 0.05).ConclusionThis study showed that the CCOS score in the PFDRT group was better than that in the PFDD group. Preoperative motor dysfunction, cerebellar-related symptoms, and different surgical methods in patients of CM-I with syringomyelia affected postoperative CCOS score. Both the duration of symptoms and the age of the patients should be actively considered as factors influencing prognosis. Symptomatic CM-I patients with syringomyelia should undergo surgical treatment as early as possible.

Additional file 4: Supplementary Materials and Methods.

Additional file 3: Supplementary Tables.

The dry reciprocating sliding properties of two weaves, reinforced twill 2/2 (RT) and basket weave 3/3 (BW), of hybrid PTFE/Kevlar fabric composites were investigated using a pin-on-flat configuration along the selected orientations of 0°, 30°, 45°, 60° and 90° which were the reciprocating sliding directions of pin to weft yarn (PTFE). The morphologies of the worn surfaces of the composites were analyzed by means of Scanning Electron Microscopy (SEM). The PTFE transfer film and F element on the counterface were observed and analyzed respectively by SEM and Energy Dispersive X-ray Spectroscopy (EDS). The results showed that the orientations and weaves played an important role in the friction reduction and antiwear properties of PTFE/Kevlar fabric composites. Contrasting to BW PTFE/Kevlar fabric composites, RT PTFE/Kevlar fabric composites showed significant advantages in the antiwear performance along all the selected orientations. The main damage forms of PTFE/Kevlar fabric composites include fatigue wear and adhesive wear of the polymer matrix, and lifted, wrinkled and breakage of the fibers.

Polytetrafluoroethylene/poly(methyl methacrylate) (PTFE/PMMA) composites were prepared by a self-curing method. The influence of heat treatment processes on the friction and wear behaviors of PTFE/PMMA composites against bearing steel balls were studied by a ball-on-disk tribometer. The thermal performance of PTFE/PMMA composites with heat treatment was analyzed by Thermogravimetric Analysis (TGA). The surface morphologies and element distribution of PTFE/PMMA composites in a PMMA matrix were detected by Field Emission Scanning Electron Microscopy (FE-SEM) and Energy Dispersive Spectroscopy (EDS). The results indicated that the wear rates of PTFE/PMMA composites with different heat treatments significantly declined compared with the unheated treatment composite. The wear rate of the PTFE/PMMA composite decreased firstly and then increased with molding temperature and time increasing, and reduced with the molding pressure increasing. The main wear mechanisms of PTFE/PMMA composites with different heat treatments were fatigue wear and abrasive wear.

Polytetrafluoroethylene/Poly(methyl methacrylate) (PTFE/PMMA) composite was prepared by mixing PTFE into PMMA matrix which synthesized by the PMMA powder mixture and methyl methacrylate (MMA) liquid mixture. The effects of the filling mass ratio of PTFE and powder/liquid (P/L) ratio on the friction and wear properties of PTFE/PMMA composites against bearing steel were studied by a ball-on-disk tribometer. Fourier transform infrared (FTIR), field emission scanning electron microscopy (FESEM), and energy dispersive X-ray spectroscopy (EDS) were used to characterize the synthesis of PTFE/PMMA composite. The shore hardness and glass transition temperature (Tg) were obtained respectively by shore hardness tester and differential scanning calorimetry (DSC). The results show that the friction coefficient and wear rate of PMMA based composite, comparing with the unfilled PMMA, can be significantly reduced by filling with PTFE. With the increasing of PTFE filling mass ratio, the wear rate of PTFE/PMMA composite increases. The friction coefficient and wear rate of the unfilled PMMA and PTFE/PMMA composite generally decrease with the P/L ratio increasing. The main wear mechanism of the unfilled PMMA is adhesive wear. While the main wear mechanisms of PTFE/PMMA composites are fatigue wear and abrasive wear.