Document Detail


Comparision of results between two different techniques of cranio-cervical decompression in patients with Chiari I malformation.
MedLine Citation:
PMID:  19742392     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: A variety of approaches are employed for treatment of Chiari I malformation. They differ in extent of cranio-c ervical decompression. A technique based on arachnoid preservation and duroplasty was introduced in our department in 2001. The aim of the study is to compare between the previous and the present technique. MATERIAL AND METHODS: Retrospective analysis of 38 patients with Chiari I malformation treated between 1998 and 2004 was performed. The previous technique including arach- noid incision, coagulation of cerebellar tonsils, and fourth ventricle exploration without duroplasty was used to treat 21 patients (group 1). A further 17 patients were treated with the present technique consisting of arachnoid preservation and duroplasty (group 2). Complication rates as well as early and late results of treatment were evaluated. Karnofsky (KPS), Rankin (RS) and Bidziński (BS) scales were used for evaluation of results. RESULTS: Post-operative complications were detected in 9 patients in group 1 (43%). They included liquorrhoea (5 cases), meningitis (1 case), and symptoms progression (3 cases). There were no surgical complications in group 2 (p = 0.002). Neurological improvement in the early period (until discharge from hospital) occurred in 10 (48%) patients in group 1 and in 13 (76%) in group 2 (p = NS). Further improvement or lack of symptoms progression was found in 58% in group 1 and 82% in group 2 (p = NS). Assessment in KPS, RS and BS showed slightly better results of group 2 but the difference was statistically insignificant. CONCLUSIONS: Results of both techniques are comparable. The risk of post-operative complications after extra-arachnoid cranio-cervical decompression with duroplasty is, however, significantly lower.
Authors:
Przemysław Kunert; Mirosław Janowski; Agnieszka Zakrzewska; Andrzej Marchel
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Neurologia i neurochirurgia polska     Volume:  43     ISSN:  0028-3843     ISO Abbreviation:  Neurol. Neurochir. Pol.     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-09-10     Completed Date:  2009-11-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0101265     Medline TA:  Neurol Neurochir Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  337-45     Citation Subset:  IM    
Affiliation:
Katedra i Klinika Neurochirurgii, Warszawski Uniwersytet Medyczny, ul. Banacha 1a, 02-097 Warszawa. pkunert@wp.pl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Arnold-Chiari Malformation / surgery*
Cerebrospinal Fluid Otorrhea / etiology
Cerebrospinal Fluid Rhinorrhea / etiology
Decompression, Surgical / adverse effects,  methods*
Disease Progression
Female
Humans
Male
Meningitis / etiology
Middle Aged
Neurosurgical Procedures / adverse effects,  methods
Retrospective Studies
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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