title: Perioperative outcomes and complications associated with allogeneic duraplasty for the management of Chiari malformations Type I in 48 pediatric patients.
abstract: OBJECTIVE
  The authors debate the optimal management for Chiari malformation Type I (CM-I) while sharing their experience with posterior fossa decompression and duraplasty (PFDD).
  
  
  METHODS
  The charts of 48 consecutive pediatric patients surgically treated for CM-I were retrospectively reviewed.
  
  
  RESULTS
  Patients ranged in age from 2 to 17 years with an average age of 9.8 years. The most common presentations were headache, affecting 34 patients (71%), and pain (neck, back, or extremities), affecting 21 patients (44%). Twenty-seven patients (56%) had a syrinx. All 48 patients underwent PFDD utilizing acellular tissue matrix. The average hospital stay overall was 3.56 days, whereas the average stay for patients with (29 [60%] of 48) or without (19 [40%] of 48) scoliosis and/or syringomyelia was 3.72 and 3.32 days, respectively. The odds of a patient having a hospital stay of 4 or more days was nearly 3 times greater in patients with scoliosis and/or syringomyelia as compared with patients without either condition (OR 2.73, 95% CI 0.74-10.11, p = 0.1330). The average hospital stay for patients 0-8 years of age was 3.29 days; and for those 9-17 years of age, 3.78 days. The odds of a patient having a hospital stay of 4 or more days was nearly 4 times greater in 9- to 17-year-olds as compared with 0- to 8-year-olds (OR 3.73, 95% CI 1.03-13.52, p = 0.0455). Forty patients (89%) experienced early improvement in their signs and symptoms following PFDD. There were 2 revision PFDDs (4%).
  
  
  CONCLUSIONS
  Posterior fossa decompression and duraplasty is a safe and effective surgical option in the management of pediatric CM-I.
authors: Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.
authors: Paul
authors: P
authors: Foreman
authors: Sam
authors: S
authors: Safavi-Abbasi
authors: Melanie C
authors: MC
authors: Talley
authors: Lindsay
authors: L
authors: Boeckman
authors: Timothy B
authors: TB
authors: Mapstone
mesh_terms: D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000601:surgery*; D001672:Biocompatible Materials; D002648:Child; D002675:Child, Preschool; D004388:Dura Mater / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials