Efficacy of Posterior Fossa Decompression with Duraplasty for Patients with Chiari Malformation Type I: A Systematic Review and Meta-Analysis

World Neurosurgery
Zhi ChaiRan Zhou

Abstract

To quantitatively assess and compare the effectiveness and safety of posterior fossa decompression with duraplasty (PFDD) and posterior fossa decompression (PFD) in treating patients with Chiari malformation type I. PubMed, Embase, and Cochrane Library were searched through May 2017. Fourteen cohort studies comprising 3666 patients with Chiari malformation type I were included. Studies were pooled, and the relative risk (RR) and corresponding 95% confidence interval (CI) were calculated. The decrease in syringomyelia was better in patients in the PFDD group than in patients in the PFD group (RR = 1.57, 95% CI = 1.07-2.32, Pheterogeneity = 0.042, I2 = 56.6%). The incidence of cerebrospinal fluid leak (RR = 5.23, 95% CI = 2.61-10.51, Pheterogeneity = 0.830, I2 = 0%) and aseptic meningitis (RR = 4.02, 95% CI = 1.46-11.03, Pheterogeneity = 0.960, I2 = 0%) significantly increased among patients in the PFDD group compared with patients in the PFD group. When stratifying by age, a significantly reduced risk in the reoperation rate was observed in the adult group. However, the clinical improvement and the incidence of wound infection were not significantly different between the 2 groups. This study confirmed that the decrease in syring...Continue Reading

Citations

Jun 19, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Luca MassimiM Caldarelli
May 28, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Tasha-Kay Walker-PalmerPaul Steinbok
Jul 29, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·H AlexanderRobert F Keating
Jul 2, 2019·Neurospine·Michael G Fehlings, Jetan H Badhiwala
Jun 12, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Arthur R KurzbuchShailendra Magdum
Jan 3, 2021·Clinical Neurology and Neurosurgery·Pasquale GalloChandrasekaran Kaliaperumal
Apr 2, 2021·Spine Deformity·V Vazquez RodriguezM A Noel
Jun 8, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Luca MassimiUNKNOWN International Experts - Jury of the Chiari & Syringomyelia Consensus Conference, “Milan, November 11–13, 2019”
Jul 8, 2021·Clinical Neurology and Neurosurgery·Angelica M FuentesAnkit I Mehta

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