Table 3.
Follow-up summary of clinical and radiological outcomes stratified by the type of grafts used, graft fixation methods and duraplasty materials during decompression surgery in patients with Chiari I malformation.
| Kind of grafts, methods of graft fixation and duraplasty pattern | Number of patients | Long-term results | Syringo-myelia present (pre-op) 54/70 (77.1%) | Syringomyelia on follow-up MRI Number of patients (%) |
Complication rate | Pseudomeningocele | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Improvement or unchanged | Deterioration | p | CCOS ≥ 12 | CCOS < 12 | p | Decreased 48/54 (88.9%) | Stable 4/54 (74%) or increased 2/54 (3.7%) | p | [−] | [+] | p | [+] | [−] | p | Average maximal thicknessa [SD] | p | |||
| Non-AutoG1 | 42 (60.0%) | 32 (76.2%) | 10 (23.8%) | 0.44 | 33 (78.6%) | 9 (21.4%) | 1 | 34 (80.9%) | 30 (88.2%) | 4 (11.8%) | 0.84 | 38 (90.5%) | 4 (9.5%) | 0.80 | 22 (52.4%) | 20 (47.6%) | < 0.05 | 4.62 (± 5.7) | < 0.05 |
| AutoG2 | 28 (40.0%) | 19 (67.9%) | 9 (32.1%) | 22 (78.6%) | 6 (21.4%) | 20 (71.4%) | 18 (90.0%) | 2 (10.0%) | 25 89.3%) | 3 (10.7%) | 3 (10.7%) | 25 (89.3%) | 0.61 (± 2.1) | ||||||
| S3 | 47 (67.1%) | 34 (72.3%) | 13 (27.7%) | 0.89 | 38 (80.9%) | 9 (19.1%) | 0.79 | 36 (76.6%) | 32 (88.9%) | 4 (11.1%) | 1 | 43 (91.5%) | 4 (8.5%) | 0.87 | 15 (31.9%) | 32 (68.1%) | 0.34 | 2.40 (± 4.4) | 0.24 |
| G4 | 23 (32.9%) | 17 (73.9%) | 6 (26.1%) | 18 (78.3%) | 5 (21.7%) | 18 (78.3%) | 16 (88.9%) | 2 (11.1%) | 20 (87.0%) | 3 (13.0%) | 10 (43.5%) | 13 (56.5%) | 4.26 (± 5.9) | ||||||
| Non-AutoG+S5 | 22 (31.4%) | 16 (72.7%) | 6 (27.3%) | 0.39 | 17 (77.3%) | 5 (22.7%) | 0.32 | 18 (81.8%) | 16 (88.9%) | 2 (11.1%) | 0.96 | 22 (100.0%) | 0 (0.0%) | 0.16 | 12 (54.5%) | 10 (45.5%) | < 0.05 | 4.36 (± 5.4) | < 0.05 |
| Non-AutoG+G6 | 20 (28.6%) | 16 (80.0%) | 4 (20.0%) | 16 (80.0%) | 4 (20.0%) | 16 (80.0%) | 14 (87.5%) | 2 (12.5%) | 16 (80.0%) | 4 (20.0%) | 10 (50.0%) | 10 (50.0%) | 4.9 (± 6.1) | ||||||
| AutoG+S7 | 25 (35.7%) | 19 (76.0%) | 6 (24.0%) | 20 (80.0%) | 5 (20.0%) | 18 (72.0%) | 16 (88.9%) | 2 (11.1%) | 22 (88.0%) | 3 (12.0%) | 3 (12.0%) | 22 (88.0%) | 0.68 (± 2.2) | ||||||
| AutoG+G8 | 3 (4.3%) | 1 (33.3%) | 2 (66.7%) | 1 (33.3%) | 2 (66.7%) | 2 (66.7%) | 2 (100.0%) | 0 (0.0%) | 3 (100.0%) | 0 (0.0%) | 0 (0.0%) | 3 (100.0%) | 0.0 (± 0.0) | ||||||
1Nonautologous graft, 2Autologous graft, 3Graft fixed with sutures, 4Graft fixed with glue only, 5Nonautologous graft fixed with sutures, 6Nonautologous graft fixed with glue only, 7Autologous graft fixed with sutures, 8Autologous graft fixed with glue only.
aMaximal perpendicular distance to graft measured on sagittal T2 MRI images (mm).