Development , validation , and incorporation of a small number of disease-specific patient-based instruments will improve the quality of research and care of CM-I patients
OBJECT Chiari malformation Type I ( CM-I ) is a common and often debilitating neurological disease .
Efforts to improve treatment of CM-I are impeded by inconsistent and limited methods of evaluating clinical outcomes .
Chiari I Malformation: Potential Role for Intraoperative Electrophysiologic Monitoring
& NA ; Intraoperative electrophysiologic monitoring can diminish the risk of neurologic injury by enabling the detection of injury at a time when it can be reversed or minimized . Although it is clear that in patients with cervical spine disease monitoring during surgery reduces the incidence of neurologic injury , almost no data are available regarding its utility in patients undergoing suboccipital decompression for Chiari I malformation . Patients with Chiari I malformation have caudal displacement of the cerebellar tonsils below the skull base , thereby creating a tight foramen magnum and cervical canal . Although the majority of pediatric neurosurgeons perform a bony decompression with duraplasty for symptomatic patients , there is much controversy regarding the amount of bony decompression required for clinical improvement and whether a duraplasty is essential . The authors therefore conducted a prospect i ve , observational study using intraoperative brainstem auditory evoked potentials ( BAEPs ) and somatosensory evoked potentials in pediatric patients undergoing suboccipital decompressions for Chiari I malformations to determine whether there were consistent changes in intraoperative BAEPs that could help the operating surgeon decide how extensive a decompression was needed in these patients , and whether changes in BAEPs or somatosensory evoked potentials occurred during operative positioning that could be modified to reduce the risk of neurologic injury
Development , validation , and incorporation of a small number of disease-specific patient-based instruments will improve the quality of research and care of CM-I patients
OBJECT Chiari malformation Type I ( CM-I ) is a common and often debilitating neurological disease .
Efforts to improve treatment of CM-I are impeded by inconsistent and limited methods of evaluating clinical outcomes .