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[Posterior decompression of the craniovertebral junction in children with Chiari malformation: a surgery extent issue].
- Source :
-
Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko [Zh Vopr Neirokhir Im N N Burdenko] 2016; Vol. 80 (4), pp. 13-20. - Publication Year :
- 2016
-
Abstract
- Aim: The study objective was to develop a rational approach for defining the extent of posterior decompression in children with Chiari 1 malformation.<br />Material and Methods: Posterior decompression was performed in 76 children with Chiari 1 malformation, under 18 years of age, in the period between 2001 and 2015. Fifty two (68%) children had syringomyelia. Extradural decompression (EDD) was performed in 14 (18%) cases, extra-arachnoid duraplasty (EAD) in 21 (28%) cases, intra-arachnoid dissection and duraplasty in 21 (28%) cases, and foramen of Magendie stenting and duraplasty in 20 (26%) cases.<br />Results: Complications occurred in 15 (20%) patients, with one of them being fatal (case fatality rate, 1.3%). The complication rate was higher after (1) intra-arachnoid dissection (p=0.0009) and stenting (p=0.02). Re-operation was required in 8 (11%) patients. The overall rate of complications and re-operations was lowest after EAD (10%).<br />Conclusion: EAD is the method of choice for Chiari 1 malformation in children. EDD can be adopted as a primary option, but it requires selection of relevant patients. Intra-arachnoid dissection, with/without stenting, is not advisable as a primary intervention, but may be inevitable in the re-operation case.
Details
- Language :
- English; Russian
- ISSN :
- 0042-8817
- Volume :
- 80
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko
- Publication Type :
- Academic Journal
- Accession number :
- 27500770
- Full Text :
- https://doi.org/10.17116/neiro201680413-20