Preoperative predictors of foramen magnum decompression with dural splitting for amelioration of syringomyelia associated with Chiari type 1 malformation.
World Neurosurg
; 2024 Sep 06.
Article
in En
| MEDLINE
| ID: mdl-39245134
ABSTRACT
OBJECTIVE:
Among several procedures for syringomyelia associated with Chiari type 1 malformation (CM-1), foramen magnum decompression (FMD) with dural splitting is one of the treatment choices with low complication rates. However, some meta-analyses have suggested that FMD with dural splitting may be inferior to FMD with duraplasty based on clinical outcomes; therefore, a predictor of a good surgical outcome with dural splitting is essential. This study aimed to clarify the preoperative parameters for good outcomes in patients with FMD with dural splitting, including the volumetric perspective.METHODS:
We reviewed the cases of patients diagnosed with CM-1 and syringomyelia who underwent FMD with dural splitting at our institution. We included patients who underwent magnetic resonance imaging (MRI) from 6 months to 1 year after surgery, and measured radiological parameters using preoperative computed tomography and preoperative/follow-up MRI.RESULTS:
Thirty-one patients were enrolled. Among all radiological parameters, the volume of the herniated tonsils (Vtonsil) and the difference between the expected volume-increment and Vtonsil (Vincr-Vtonsil) in improved groups were significantly smaller than those in non-improved groups. To predict the improvement of the syrinx, Vincr-Vtonsil of 0.77 mL was the optimal cutoff value, and yielded 100% sensitivity and 48.0% specificity.CONCLUSIONS:
Vtonsil and Vincr-Vtonsil, which are novel predictors based on the volumetric perspective, might be the optimal predictors for improvement of the syrinx associated with CM-1 by 1 year after surgery.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
World Neurosurg
Journal subject:
NEUROCIRURGIA
Year:
2024
Document type:
Article
Country of publication: