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Journal Article Ppublish 4 citations

PubMed: 35758154 DOI: 10.1080/01616412.2022.2089402

Possible predictive clinical and radiological markers in decision making for surgical intervention in patients with Chiari Malformation type 1.

Neurol Res 44(11):975-988

Authors: Ulaş Yuksel, Veysel Burulday, Suleyman Akkaya, Selcuk Baser, Mustafa Ogden, Aslihan Alhan, Bulent Bakar

Affiliations

  • Kirikkale University Faculty of Medicine, Department of Neurosurgery, Kirikkale, Turkey.
  • Inonu University Faculty of Medicine, Department of Radiology, Kirikkale, Turkey.
  • Kirikkale University Faculty of Medicine, Department of Radiology, Kirikkale, Turkey.
  • Ufuk University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey.

Abstract

BACKGROUND

The first aim of this study was to compare the clinical data and posterior fossa morphometry obtained during the admission to the hospital between control group individuals (who had not Chiari Malformation (CM) type 1) and CM type 1 patients treated surgically or not. The second aim was to create a valid and reliable scale that can predict the decision-making for surgical intervention simply and easily in these patients.

MATERIALS

Medical data and radiological images of 70 CM type 1 patients during their admission to the hospital were compared with the data of 69 control group individuals.

RESULTS

Conservative treatment and/or follow-up was applied to 58 (82.9%) patients, and 12 (17.1%) patients underwent surgery. analysis showed that the presence of myelopathy, tonsillar herniation >8 mm, Chamberlain line >84 mm, McRae line >44.50 mm, and odontoid process-McRae line angle <10.50 degrees could be used as predictive markers in decision-making for surgical intervention (p < 0.05). analysis revealed that symptoms severity, and McRae line value would be the 'best parameters' in decision-making for surgical intervention (p < 0.05). A scale named the CHIASURG scale developed using this study's parameters showed that the parameters of 'depth of tonsillar herniation', 'Chamberlain line', and 'McRae line' could predict the surgical intervention risk.

CONCLUSION

It was found that symptoms severity and McRae line value could be used as predictive markers in decision-making for surgical intervention. Additionally, it was concluded that a new scale called CHIASURG could predict surgical intervention risk validly and reliably.

MeSH

Risk, Decision Making

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