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RT Journal Article
SR Electronic
T1 Prospective, Longitudinal Study of Clinical Outcome and Morphometric Posterior Fossa Changes after Craniocervical Decompression for Symptomatic Chiari I Malformation
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1150
OP 1156
DO 10.3174/ajnr.A7993
VO 44
IS 10
A1 Ibrahimy, Alaaddin
A1 Wu, Tianxia
A1 Mack, Jessica
A1 Scott, Gretchen C.
A1 Cortes, Michaela X.
A1 Cantor, Fredric K.
A1 Loth, Francis
A1 Heiss, John D.
YR 2023
UL http://www.ajnr.org/content/44/10/1150.abstract
AB BACKGROUND AND PURPOSE: The time course of changes in posterior fossa morphology, quality of life, and neurologic function of patients with Chiari I malformation after craniocervical decompression requires further elaboration. To better understand the pace of these changes, we longitudinally studied patients with Chiari I malformation, with or without syringomyelia, before and after the operation for up to 5 years.MATERIALS AND METHODS: Thirty-eight symptomatic adult patients (35 women, 3 men) diagnosed with Chiari I malformation only (n = 15) or Chiari I malformation and syringomyelia (n = 23) and without previous Chiari I malformation surgery were enrolled in a clinical study. Patients underwent outpatient study visits and MR imaging at 7 time points (ie, initial [before the operation], 3 months, 1 year, 2 years, 3 years, 4 years, and 5 years) during 5 years. The surgical procedure for all patients was suboccipital craniectomy, C1 laminectomy, and autologous duraplasty.RESULTS: Morphometric measurements demonstrated an enlargement of the CSF areas posterior to the cerebellar tonsils after the operation, which remained largely stable through the following years. There was a decrease in pain and improved quality of life after the operation, which remained steady during the following years. Reduction in pain and improved quality of life correlated with CSF area morphometrics.CONCLUSIONS: Most changes in MR imaging morphometrics and quality of life measures occurred within the first year after the operation. A 1-year follow-up period after Chiari I malformation surgery is usually sufficient for evaluating surgical efficacy and postoperative MR imaging changes.CMIChiari I malformationKPSKarnofsky Performance ScaleLSleast squarePFDposterior fossa and foramen magnum decompression surgeryPCFposterior cranial fossaPFDDPFD with dural opening and duraplastyRM-ANCOVArepeated measures ANCOVARM-ANOVArepeated-measures ANOVATPtime point