التفاصيل البيبلوغرافية
| العنوان: |
Surgical Management after Chiari Decompression Failure: Craniovertebral Junction Revision versus Shunting Strategies |
| المؤلفون: |
Steven Knafo, Mihai Malcoci, Silvia Morar, Fabrice Parker, Nozar Aghakhani |
| المصدر: |
Journal of Clinical Medicine; Volume 11; Issue 12; Pages: 3334 |
| بيانات النشر: |
Multidisciplinary Digital Publishing Institute |
| سنة النشر: |
2022 |
| المجموعة: |
MDPI Open Access Publishing |
| مصطلحات موضوعية: |
Chiari malformation, surgery, foramen magnum decompression, shunt |
| الوصف: |
Revision surgery after posterior fossa decompression for Chiari malformation is not uncommon and poses both strategic and technical challenges. We conducted a single-center retrospective cohort study including all adult patients who underwent revision surgery after posterior fossa decompression for Chiari type I malformation between 2010 and 2019. Among 311 consecutive patients operated on for Chiari malformation at our institution, 35 patients had a least one revision surgery with a mean follow-up of 70.2 months. Mean delay for revision was 28.8 months. First revision surgery was performed at the level of the foramen magnum in 25/35 cases and consisted in duraplasty revision in all cases, arachnolysis (51.4%), additional bone decompression (37.1%), tonsillar coagulation or resection (25.7%), 4th ventricle to cervical subarachnoid spaces shunt (5.7%). Most repeat revisions consisted in CSF diversion procedures, with either ventriculo-peritoneal or syringo-peritoneal shunts. Mean number of interventions per patient was 3.2, with 22.9% of patients undergoing 4 or more surgeries. Based on our experience, we propose that revision at the level of the foramen magnum should be considered as a first-line strategy for Chiari decompression failure. Shunting procedures can be performed in case of extensive arachnoiditis or repeated failures. |
| نوع الوثيقة: |
text |
| وصف الملف: |
application/pdf |
| اللغة: |
English |
| العلاقة: |
Clinical Neurology; https://dx.doi.org/10.3390/jcm11123334Test |
| DOI: |
10.3390/jcm11123334 |
| الإتاحة: |
https://doi.org/10.3390/jcm11123334Test |
| حقوق: |
https://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: |
edsbas.FA919DED |
| قاعدة البيانات: |
BASE |
