Outcomes of dura-splitting technique compared to conventional duraplasty technique in the treatment of adult Chiari I malformation: a systematic review and meta-analysis.
Arnold-Chiari Malformation
/ diagnostic imaging
Blood Loss, Surgical
/ prevention & control
Databases, Factual
/ trends
Decompression, Surgical
/ methods
Dura Mater
/ diagnostic imaging
Foramen Magnum
/ diagnostic imaging
Humans
Observational Studies as Topic
/ methods
Plastic Surgery Procedures
/ methods
Retrospective Studies
Treatment Outcome
Chiari malformation type I
Dura splitting
Duraplasty
Outcome
Journal
Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
18
03
2020
accepted:
08
06
2020
revised:
14
05
2020
pubmed:
23
6
2020
medline:
14
7
2021
entrez:
23
6
2020
Statut:
ppublish
Résumé
Chiari malformation type I is a developmental abnormality with an array of surgical techniques introduced for the management of it. The most common technique is foramen magnum decompression with duraplasty. Dura-splitting technique as one of the non-dura-opening techniques is a less known procedure that spares the internal layer of the dura and can theoretically result in fewer complications compared to duraplasty. So, we performed a review of literature and meta-analysis on different clinical and radiological aspects of this technique and compared its outcomes to duraplasty. MOOSE guidelines were followed. A systematic search of three databases based on predefined search strategy and inclusion/exclusion criteria was performed. After quality assessment and data extraction by two authors, summarized data were presented in form of tables, and meta-analysis results were illustrated in forest plots. A review of 10 included studies consisting of 370 patients revealed significantly shorter operation duration and less intraoperative blood loss in the dura-splitting technique compared to duraplasty. Interestingly, there was no significant difference between these two techniques in terms of clinical and radiological outcomes. Overall complication rate and incidence of CSF-related complications or infections were significantly in favor of the dura-splitting technique. Dura-splitting technique can be considered as a safe and effective surgical procedure for Chiari I malformation with comparable outcomes and fewer complications compared to duraplasty, although this interpretation is derived from retrospective observational studies and lack of a prospective clinical trial is evident.
Identifiants
pubmed: 32567026
doi: 10.1007/s10143-020-01334-y
pii: 10.1007/s10143-020-01334-y
doi:
Types de publication
Comparative Study
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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