Occipital-Cervical Fusion and Ventral Decompression in the Surgical Management of Chiari-1 Malformation and Syringomyelia: Analysis of Data From the Park-Reeves Syringomyelia Research Consortium
dc.contributor.author | CreveCoeur, Travis S. | |
dc.contributor.author | Yahanda, Alexander T. | |
dc.contributor.author | Maher, Cormac O. | |
dc.contributor.author | Johnson, Gabrielle W. | |
dc.contributor.author | Ackerman, Laurie L. | |
dc.contributor.author | Adelson, P. David | |
dc.contributor.author | Ahmed, Raheel | |
dc.contributor.author | Albert, Gregory W. | |
dc.contributor.author | Aldana, Phillipp R. | |
dc.contributor.author | Alden, Tord D. | |
dc.contributor.author | Anderson, Richard C.E. | |
dc.contributor.author | Baird, Lissa | |
dc.contributor.author | Bauer, David F. | |
dc.contributor.author | Bierbrauer, Karin S. | |
dc.contributor.author | Brockmeyer, Douglas L. | |
dc.contributor.author | Chern, Joshua J. | |
dc.contributor.author | Couture, Daniel E. | |
dc.contributor.author | Daniels, David J. | |
dc.contributor.author | Dauser, Robert C. | |
dc.contributor.author | Durham, Susan R. | |
dc.contributor.author | Ellenbogen, Richard G. | |
dc.contributor.author | Eskandari, Ramin | |
dc.contributor.author | Fuchs, Herbert E. | |
dc.contributor.author | George, Timothy M. | |
dc.contributor.author | Grant, Gerald A. | |
dc.contributor.author | Graupman, Patrick C. | |
dc.contributor.author | Greene, Stephanie | |
dc.contributor.author | Greenfield, Jeffrey P. | |
dc.contributor.author | Gross, Naina L. | |
dc.contributor.author | Guillaume, Daniel J. | |
dc.contributor.author | Haller, Gabe | |
dc.contributor.author | Hankinson, Todd C. | |
dc.contributor.author | Heuer, Gregory G. | |
dc.contributor.author | Iantosca, Mark | |
dc.contributor.author | Iskandar, Bermans J. | |
dc.contributor.author | Jackson, Eric M. | |
dc.contributor.author | Jea, Andrew H. | |
dc.contributor.author | Johnston, James M. | |
dc.contributor.author | Keating, Robert F. | |
dc.contributor.author | Kelly, Michael P. | |
dc.contributor.author | Khan, Nickalus | |
dc.contributor.author | Krieger, Mark D. | |
dc.contributor.author | Leonard, Jeffrey R. | |
dc.contributor.author | Mangano, Francesco T. | |
dc.contributor.author | Mapstone, Timothy B. | |
dc.contributor.author | McComb, J. Gordon | |
dc.contributor.author | Menezes, Arnold H. | |
dc.contributor.author | Muhlbauer, Michael | |
dc.contributor.author | Oakes, W. Jerry | |
dc.contributor.author | Olavarria, Greg | |
dc.contributor.author | O’Neill, Brent R. | |
dc.contributor.author | Park, Tae Sung | |
dc.contributor.author | Ragheb, John | |
dc.contributor.author | Selden, Nathan R. | |
dc.contributor.author | Shah, Manish N. | |
dc.contributor.author | Shannon, Chevis | |
dc.contributor.author | Shimony, Joshua S. | |
dc.contributor.author | Smith, Jodi | |
dc.contributor.author | Smyth, Matthew D. | |
dc.contributor.author | Stone, Scellig S.D. | |
dc.contributor.author | Strahle, Jennifer M. | |
dc.contributor.author | Tamber, Mandeep S. | |
dc.contributor.author | Torner, James C. | |
dc.contributor.author | Tuite, Gerald F. | |
dc.contributor.author | Wait, Scott D. | |
dc.contributor.author | Wellons, John C., III. | |
dc.contributor.author | Whitehead, William E. | |
dc.contributor.author | Limbrick, David D., Jr. | |
dc.contributor.department | Neurological Surgery, School of Medicine | en_US |
dc.date.accessioned | 2023-04-17T11:13:04Z | |
dc.date.available | 2023-04-17T11:13:04Z | |
dc.date.issued | 2021-01-13 | |
dc.description.abstract | Background: Occipital-cervical fusion (OCF) and ventral decompression (VD) may be used in the treatment of pediatric Chiari-1 malformation (CM-1) with syringomyelia (SM) as adjuncts to posterior fossa decompression (PFD) for complex craniovertebral junction pathology. Objective: To examine factors influencing the use of OCF and OCF/VD in a multicenter cohort of pediatric CM-1 and SM subjects treated with PFD. Methods: The Park-Reeves Syringomyelia Research Consortium registry was used to examine 637 subjects with cerebellar tonsillar ectopia ≥ 5 mm, syrinx diameter ≥ 3 mm, and at least 1 yr of follow-up after their index PFD. Comparisons were made between subjects who received PFD alone and those with PFD + OCF or PFD + OCF/VD. Results: All 637 patients underwent PFD, 505 (79.2%) with and 132 (20.8%) without duraplasty. A total of 12 subjects went on to have OCF at some point in their management (PFD + OCF), whereas 4 had OCF and VD (PFD + OCF/VD). Of those with complete data, a history of platybasia (3/10, P = .011), Klippel-Feil (2/10, P = .015), and basilar invagination (3/12, P < .001) were increased within the OCF group, whereas only basilar invagination (1/4, P < .001) was increased in the OCF/VD group. Clivo-axial angle (CXA) was significantly lower for both OCF (128.8 ± 15.3°, P = .008) and OCF/VD (115.0 ± 11.6°, P = .025) groups when compared to PFD-only group (145.3 ± 12.7°). pB-C2 did not differ among groups. Conclusion: Although PFD alone is adequate for treating the vast majority of CM-1/SM patients, OCF or OCF/VD may be occasionally utilized. Cranial base and spine pathologies and CXA may provide insight into the need for OCF and/or OCF/VD. | en_US |
dc.eprint.version | Final published version | en_US |
dc.identifier.citation | CreveCoeur TS, Yahanda AT, Maher CO, et al. Occipital-Cervical Fusion and Ventral Decompression in the Surgical Management of Chiari-1 Malformation and Syringomyelia: Analysis of Data From the Park-Reeves Syringomyelia Research Consortium. Neurosurgery. 2021;88(2):332-341. doi:10.1093/neuros/nyaa460 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/32414 | |
dc.language.iso | en_US | en_US |
dc.publisher | Wolters Kluwer | en_US |
dc.relation.isversionof | 10.1093/neuros/nyaa460 | en_US |
dc.relation.journal | Neurosurgery | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | PMC | en_US |
dc.subject | Chiari malformation | en_US |
dc.subject | Clivo-axial angle | en_US |
dc.subject | Craniovertebral junction | en_US |
dc.subject | Occipital-cervical fusion | en_US |
dc.subject | Syringomyelia | en_US |
dc.subject | Ventral brainstem compression | en_US |
dc.subject | pB-C2 | en_US |
dc.title | Occipital-Cervical Fusion and Ventral Decompression in the Surgical Management of Chiari-1 Malformation and Syringomyelia: Analysis of Data From the Park-Reeves Syringomyelia Research Consortium | en_US |
dc.type | Article | en_US |
ul.alternative.fulltext | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803430/ | en_US |