Evaluation of Adult and Pediatric Chiari Type 1 Malformation Patients: Do Consensus Documents Fit Everyday Practice?

Q2 Medicine

Acta neurochirurgica. Supplement Pub Date : 2023-01-01 DOI:10.1007/978-3-031-36084-8_24

Laura Grazia Valentini, Tommaso Francesco Galbiati, Veronica Saletti, Mariangela Farinotti, Alessandra Erbetta, Carolina Croci, Ignazio Gaspare Vetrano

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引用次数: 0

Abstract

The management of Chiari 1 malformation (CM1) and Syringomyelia (Syr) has shown many changes in surgical indications and techniques over time. The dedicated neurosurgical and neurological community recently planned to analyze the state of the art and find conduct uniformity. This led to international consensus documents on diagnostic criteria and therapeutic strategies. We aimed to evaluate, in a large, monocentric surgical series of adult and children CM1 patients, if the daily clinical practice reflects the consensus documents. Our series comprises 190 pediatric and 220 adult Chiari patients submitted to surgery from 2000 to 2021. The main indications for the treatment were the presence of Syr and symptoms related to CM1. While there is great correspondence with the statements derived from the consensus documents about what to do for Syr and symptomatic CM1, the accordance is less evident in CM1 associated with craniosynostosis or hydrocephalus, especially when considering the early part of the series. However, we think that performing such studies could increase the homogeneity of surgical series, find a common way to evaluate long-term outcomes, and reinforce the comparability of different strategies adopted in different referral centers.

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评估成人和小儿 Chiari 1 型畸形患者：共识文件是否适合日常实践？

随着时间的推移，Chiari 1畸形（CM1）和鞘膜积液（Syr）的手术适应症和技术发生了许多变化。最近，专门的神经外科和神经病学界计划对技术现状进行分析，以找到统一的方法。这促成了关于诊断标准和治疗策略的国际共识文件。我们的目标是通过对成人和儿童 CM1 患者的大型单中心手术系列，评估日常临床实践是否反映了共识文件的要求。我们的系列研究包括 2000 年至 2021 年期间接受手术治疗的 190 名儿童和 220 名成年 Chiari 患者。治疗的主要指征是出现与 CM1 相关的 Syr 和症状。虽然与共识文件中关于如何治疗Syr和有症状的CM1的声明有很大的一致性，但对于伴有颅骨发育不良或脑积水的CM1，这种一致性并不明显，尤其是考虑到该系列的早期部分。然而，我们认为开展此类研究可以提高手术系列的同质性，找到评估长期结果的通用方法，并加强不同转诊中心所采取的不同策略的可比性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta neurochirurgica. Supplement Medicine-Surgery

CiteScore

1.90

自引率

0.00%

发文量

期刊介绍： In addition to the regular journal, "Acta Neurochirurgica" publishes 3-4 supplement volumes per year. These comprise proceedings of international meetings or other material of general neurosurgical interest.