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Dura Management Str...
Dura Management Strategies in the Surgical Treatment of Adult Chiari Type I Malformation : A Retrospective, Multicenter, Population-Based Parallel Cohort Case Series
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- Kristiansson, Helena (författare)
- Karolinska Univ Hosp, Dept Neurosurg, Eugeniavagen 6, S-17164 Stockholm, Sweden.;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
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- Fletcher-Sandersjöö, Alexander (författare)
- Karolinska Institutet
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- Cesarini, Kristina G (författare)
- Uppsala universitet,Neurokirurgi,Uppsala Univ Hosp, Dept Neurosurg, Uppsala, Sweden.
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- Fransson, Marcus (författare)
- Linköping Univ Hosp, Dept Neurosurg, Linköping, Sweden.,Region Östergötland, Neurokirurgiska kliniken US
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- Vlachogiannis, Pavlos (författare)
- Uppsala universitet,Neurokirurgi,Uppsala Univ Hosp, Dept Neurosurg, Uppsala, Sweden.
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- Burström, Gustav (författare)
- Karolinska Institutet
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- Hessington, Amel (författare)
- Uppsala universitet,Neurokirurgi,Uppsala Univ Hosp, Dept Neurosurg, Uppsala, Sweden.
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- Bartek, Jiri (författare)
- Karolinska Institutet
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- Edström, Erik (författare)
- Karolinska Institutet
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- Holmgren, Rafael (författare)
- Linköpings universitet,Avdelningen för neurobiologi,Medicinska fakulteten,Region Östergötland, Neurokirurgiska kliniken US
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- Sköld, Mattias K. (författare)
- Uppsala universitet,Neurokirurgi,Uppsala Univ Hosp, Dept Neurosurg, Uppsala, Sweden.
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- Elmi-Terander, Adrian (författare)
- Karolinska Institutet
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Karolinska Institutet Karolinska Univ Hosp, Dept Neurosurg, Eugeniavagen 6, S-17164 Stockholm, Sweden;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden. (creator_code:org_t)
- 2022-08-10
- 2022
- Engelska.
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Ingår i: Operative Neurosurgery. - : Lippincott Williams & Wilkins. - 2332-4252 .- 2332-4260. ; 23:4, s. 304-311
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Symptomatic Chiari I malformation is treated with suboccipital decompression and C1 laminectomy. However, whether the dura should be opened (durotomy) or enlarged with a graft (duraplasty) remains unclear. OBJECTIVE: To compare outcomes in adult Chiari I malformation patients treated with duraplasty, durotomy, or without dural opening ("mini-decompression").METHODS: A retrospective, multicenter, population-based cohort study was performed of all adult patients surgically treated for a Chiari I malformation at 3 regional neurosurgical centers between 2005 and 2017. Three different dura management strategies were favored by the participating hospitals, with data stratified accordingly. The primary outcome was measured using the Chicago Chiari Outcome Scale (CCOS), dichotomized into favorable (CCOS >= 13) or unfavorable (CCOS <= 12). Propensity score matching was used to adjust for potential confounders in outcome comparisons.RESULTS: In total, 318 patients were included, of whom 52% were treated with duraplasty, 37% with durotomy, and 11% with mini-decompression. In total, 285 (90%) showed a favorable surgical outcome (CCOS >= 13). Duraplasty was associated with more favorable CCOS and shorter hospital stay compared with durotomy, both in unadjusted (93% vs 84%. P = .018 and 6.0 vs 8.0 days, P < .001) and adjusted analyses (92% vs 84%, P = .044 and 6.0 vs 8.0 days, P < .001). Mini-decompression was excluded from the adjusted analyses because of its small sample size.CONCLUSION: In this study of adult Chiari I malformation, posterior fossa decompression with duraplasty was associated with more favorable postoperative outcome, as determined by the CCOS, compared with posterior fossa decompression with durotomy alone.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Nyckelord
- Chiari I malformation
- Case series
- Duraplasty
- Durotomy
- Occipitocervical decompression
- Syringomyelia
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- ref (ämneskategori)
- art (ämneskategori)
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Kristiansson, He ...
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Fletcher-Sanders ...
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Cesarini, Kristi ...
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Fransson, Marcus
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Vlachogiannis, P ...
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Burström, Gustav
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visa fler...
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Hessington, Amel
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Bartek, Jiri
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Edström, Erik
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Holmgren, Rafael
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Sköld, Mattias K ...
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Elmi-Terander, A ...
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- MEDICIN OCH HÄLSOVETENSKAP
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och Klinisk medicin
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och Neurologi
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Operative Neuros ...
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Uppsala universitet
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Linköpings universitet
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Karolinska Institutet