评估成人I型Chiari畸形长期预后的新指标:枕颈硬脑膜成角(ODA)-应用和价值。

IF 2.4 3区 医学 Q3 NEUROSCIENCES
Bo Wang, Shi-Chao Chen, Yao-Wu Zhang, Wei-Hao Liu, Chong Wang, Yi-Xiang Liu, Guang-Hao Zheng, Jia-Lin Li, Kai Ji, Jun Yang, Yong-Zhi Wang, Wen-Qing Jia
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引用次数: 0

摘要

硬脑膜成形术(FMDD)是治疗成人I型Chiari畸形(CM-I)的常用手术,其改良率为60-70%,但缺乏评估指标。本研究应用枕颈硬脑膜成角(ODA)的概念,旨在探讨ODA在评估长期FMDD预后中的作用。测量230名健康人的ODA正常范围。我们纳入了160名患有FMDD超过10年的CM-I型成人。采用Chicago Chiari结局量表(CCOS)评估长期结局(bb0 - 1年)。对该队列进行分组,以分析ODA在评估和预测FMDD结果中的作用。ODA正常范围为104°-145°,平均值为124.2±10.4°。患者年龄中位数为46岁(范围:18-64岁)。中位随访时间为64.5个月(范围:18-123个月)。根据术前ODA将队列分为两组:A组(n = 90), ODA 10°和bb0 3°可作为A组和B组的可信阈值。ODA是预测预后的可靠指标。FMDD应导致ODA增加,这是手术有效性的标准之一,特别是对于术前ODA为的患者
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Novel Metric for Assessing Long-Term Outcomes in Adults with Chiari Malformation Type I: Occipitocervical Dura Angulation (ODA)-Applications and Value.

Foramen magnum decompression with duraplasty (FMDD), a common surgery for adult Chiari malformation type I(CM-I) with a 60-70% improvement rate, lacks assessment metrics. This study applied the concept of occipitocervical dura angulation (ODA) and aimed to investigate ODA's role in evaluating long-term FMDD outcomes. The ODA normal range was measured in 230 healthy individuals. We included 160 CM-I adults who underwent FMDD over 10 years. Long-term outcomes (> 1 year) were evaluated using the Chicago Chiari Outcome Scale(CCOS). The cohort was grouped to analyze ODA's role in assessing and predicting FMDD outcomes. The normal range of ODA was 104°-145°, with an average value of 124.2 ± 10.4°. The median patient age was 46 years (range: 18-64 years). The median follow-up period was 64.5 months (range: 18-123 months). The cohort was divided into two groups based on preoperative ODA: group A (n = 90) with ODA < 125° and group B (n = 70) with ODA ≥ 125°. Group B had a significantly better prognosis than that of group A (P = 0.012). Logistic regression analysis revealed that an increase in ODA was associated with clinical outcomes in both groups. The receiver operating characteristic curve showed that ODA increases of > 10° and > 3° could be considered as credible threshold values for groups A and B, respectively. ODA is a reliable predictor of prognosis. FMDD should result in an increased ODA, which is one of the criteria for surgical validity, especially for those with a preoperative ODA of < 125°.

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来源期刊
Cerebellum
Cerebellum 医学-神经科学
CiteScore
6.40
自引率
14.30%
发文量
150
审稿时长
4-8 weeks
期刊介绍: Official publication of the Society for Research on the Cerebellum devoted to genetics of cerebellar ataxias, role of cerebellum in motor control and cognitive function, and amid an ageing population, diseases associated with cerebellar dysfunction. The Cerebellum is a central source for the latest developments in fundamental neurosciences including molecular and cellular biology; behavioural neurosciences and neurochemistry; genetics; fundamental and clinical neurophysiology; neurology and neuropathology; cognition and neuroimaging. The Cerebellum benefits neuroscientists in molecular and cellular biology; neurophysiologists; researchers in neurotransmission; neurologists; radiologists; paediatricians; neuropsychologists; students of neurology and psychiatry and others.
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