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 .
Long-term results after posterior fossa decompression in syringomyelia with adult Chiari Type I malformation.
OBJECT There is little information about the long-term effectiveness and complications following decompressive surgery for syringomyelia related to Chiari malformation Type I ( CM-I ) . METHODS Examining long-term clinical and radiological follow-up , the authors studied a mixed retrospective and prospect i ve single-institution cohort of 109 consecutive surgically treated adult patients with syringomyelia and CM-I. All patients underwent a st and ardized surgical protocol : decompression of the craniocervical junction , arachnoid exploration , and shrinkage of the cerebellar tonsils . Factors predicting outcome were investigated . RESULTS The retrospective arm consisted of 41 cases treated between 1990 and 1994 , and the prospect i ve arm comprised 68 patients treated between 1994 and 2001 . The mean overall age was 45.9 years , and 58.8 % of the population was female . The median follow-up period was 12.7 years . The most frequent initial symptoms were pain and sensory and gait disturbances . There was no perioperative death or neurological deterioration . The comprehensive perioperative complication rate was approximately 11 % , with 3 cases ( 2.7 % ) of CSF leakage . Regression analysis showed that the best combination of clinical and radiological outcome predictors was age and duration of symptoms . Clinical follow-up confirmed surgical result stability with clinical improvement of greater than 90 % of the spinal and cranial manifestations over a long-term period . Two patients had radiological recurrences of syringomyelia without clinical signs 85 and 124 months after surgery . CONCLUSIONS Certain clinical predictors of poor clinical and radiological prognosis were identified-namely , age at time of surgery and symptom duration . The results of the study provide additional long-term data that support the effectiveness and safety of relieving CSF block at the craniocervical junction in CM-I-related syringomyelia
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 .