Background: Revision surgery for patients with persistent, recurrent, or progressive syringomyelia following foramen magnum decompression (FMD) for Chiari malformation I-syringomyelia (CM-SM) is not uncommon and presents both strategic and technical challenges.
Methods: We conducted a retrospective study including all patients who underwent revision Cerebellar Tonsillectomy (CTL) for CM-SM between 2003 and 2023. Additionally, we performed uni- and multivariate analyses to identify possible factors contributing to failed CTL outcomes.
Results: Sixty-three consecutive patients (13 males; average age 45.86±11.18 years) underwent surgical treatment for persistent (n=29), progressive (n=21), or recurrent (n=13) syringomyelia, with an average interval of 65.57±73.33 months (range: 3-480 months) between the two surgeries. Factors significantly associated with the effectiveness of the revision CTL included dural incision and tonsil manipulation during the first surgery, severe intradural adhesions during the revision CTL, and spinal cord atrophy before the revision CTL. Multivariate logistic regression revealed that dural incision (P=0.031, OR=6.779, 95%CI (1.187∼38.719)), tonsillar manipulation (P=0.037, OR=7.432, 95%CI (1.131∼48.835)), and severe intradural adhesions (P=0.030, OR=11.465, 95%CI (1.264∼103.967)) constituted risk factors significantly statistical associated with prognosis outcomes. Long-term follow-up (average 18.75±6.86 months, range: 12-72 months) of revision CTL demonstrated clinical stabilization in 55.6% of cases for at least 1.5 years. The complication rate for revision CTL was 14.3% (n=9).
Conclusion: Dural incision and tonsillar manipulation during the first surgery, spinal cord atrophy prior to revision CTL, and severe intradural adhesions during revision CTL are significant risk factors associated with poor prognosis in revision surgery for CM-SM.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.wneu.2025.123690 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effectiveness of Cerebellar Tonsillectomy Treatment for Revision Chiari Malformation Surgery: a series of 63 patients.
World Neurosurg
January 2025
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University; Spine Center, China International Neuroscience Institute (CHINA-INI); Research Center of Spine and Spinal Cord, Beijing Institute of Brain Disorders, Capital Medical University; Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI); National Center for Neurological Disorders, Beijing, CHINA. Electronic address:
Background: Revision surgery for patients with persistent, recurrent, or progressive syringomyelia following foramen magnum decompression (FMD) for Chiari malformation I-syringomyelia (CM-SM) is not uncommon and presents both strategic and technical challenges.
Methods: We conducted a retrospective study including all patients who underwent revision Cerebellar Tonsillectomy (CTL) for CM-SM between 2003 and 2023. Additionally, we performed uni- and multivariate analyses to identify possible factors contributing to failed CTL outcomes.
Lymphatic plastic bronchitis: a study based on CT and MR lymphangiography.
BMC Med Imaging
December 2024
Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Yangfangdian Tieyiyuan Road No.10, Haidian District, Beijing, 100038, China.
Objectives: To investigate the diagnostic value of CT lymphangiography (CTL) and non-contrast MR lymphangiography (MRL) in lymphatic plastic bronchitis.
Materials And Methods: The clinical and imaging data of 31 patients with lymphatic plastic bronchitis diagnosed by clinical, imaging and pathological results were retrospectively analyzed. All patients underwent CTL and MRL.
Bleeding Risk of Cold Versus Hot Snare Polypectomy for Pedunculated Colorectal Polyps Measuring 10 mm or Less: Subgroup Analysis of a Large Randomized Controlled Trial.
Am J Gastroenterol
November 2024
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Introduction: Concerns regarding bleeding remain in cold snare polypectomy (CSP) for small pedunculated (0-Ip) polyps. The aim of this study was to compare the risk of CSP and hot snare polypectomy (HSP) for such lesions.
Methods: Data on 0-Ip colorectal polyps ≤10 mm were extracted from a large, pragmatic, randomized trial.
The Effect of C2 Muscular Exposure Technique on Radiographic and Clinical Outcomes After C2-T2 Posterior Cervical Fusion.
Clin Spine Surg
December 2024
Department of Orthopedic Surgery.
Study Design: Retrospective cohort analysis.
Objective: To determine whether the C2 exposure technique was a predictor of change in cervical alignment and patient-reported outcomes measures (PROMs) after posterior cervical decompression and fusion (PCDF) for degenerative indications.
Background: In PCDF handling of the C2 posterior paraspinal musculature during the operative approach varies by surgeon technique.
Hyaluronic acid-British anti-Lewisite as a safer chelation therapy for the treatment of arthroplasty-related metallosis.
Proc Natl Acad Sci U S A
November 2023
The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, Farmington, CT 06030.
Cobalt-containing alloys are useful for orthopedic applications due to their low volumetric wear rates, corrosion resistance, high mechanical strength, hardness, and fatigue resistance. Unfortunately, these prosthetics release significant levels of cobalt ions, which was only discovered after their widespread implantation into patients requiring hip replacements. These cobalt ions can result in local toxic effects-including peri-implant toxicity, aseptic loosening, and pseudotumor-as well as systemic toxic effects-including neurological, cardiovascular, and endocrine disorders.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!