Document Detail

Duraplasty or not? An evidence-based review of the pediatric Chiari I malformation.
MedLine Citation:
PMID:  20890606     Owner:  NLM     Status:  In-Process    
OBJECTIVES: Few studies are available that directly compare dural opening with and without additional intradural maneuvers. Therefore, the current review analyzed the available literature regarding this topic.
METHODS: An Ovid MEDLINE search was completed using each of the terms "Chiari malformation," "syringomyelia," "syrinx," "syringohydromyelia" in combination with "child" or "pediatric." Publications were considered relevant if they reported the results of posterior fossa decompression without dural opening (PFD) to posterior fossa decompression with duraplasty (PFDD). The included studies were divided into three categories based upon the surgical techniques studied. The first group of papers included works that directly compared PFD to PFDD. The second group included studies in which all patients were treated with PFD. The third group included studies in which all patients were treated with PFDD. Three outcome parameters were assessed: (1) improvement of clinical signs/symptoms, (2) syrinx resolution, and (3) scoliosis progression.
RESULTS: At this time, there is no level I or IIa evidence comparing PFD with PFDD. The notions that PFDD has a lower rate of reoperation and that PFD has a lower rate of cerebrospinal fluid-related complications are both based on IIb/B evidence.
CONCLUSIONS: Prospective randomized trials are necessary for definitive comments regarding the success of PFD and PFDD.
Todd Hankinson; R Shane Tubbs; John C Wellons
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Publication Detail:
Type:  Journal Article     Date:  2010-10-02
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  27     ISSN:  1433-0350     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  35-40     Citation Subset:  IM    
Pediatric Neurosurgery, Children's Hospital, 1600 7th Avenue South, Birmingham, AL 35233, USA.
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