Prognostic analysis of surgical treatment of Chiari malformation type 1 complicated with syringomyelia

Abstract

Objective To investigate the risk factors for poor prognosis of patients with Chiari malformation type 1 (CM1) complicated with syringomyelia treated by posterior fossa decompression with duraplasty (PFDD). Methods Forty ⁃ seven patients with CM1 complicated with syringomyelia who underwent PFDD at Zhongnan Hospital of Wuhan University from January 2013 to June 2020 were included. The prognosis was evaluated by the traditional evaluation criteria and Chicago Chiari Outcome Scale (CCOS) at 6 months postoperatively, and univariate and multivariate stepwise Logistic regression analyses were performed to screen for risk factors associated with poor outcome. Results Based on whether the CCOS score was greater than 12, 47 patients were divided into the cured group (n = 21) and uncured group (n = 26). Patients in the uncured group had longer disease duration (t = 4.709, P = 0.000) and greater syringomyelia width (t = 3.074, P = 0.004) than the cured group. Multivariable Logistic regression analysis showed that the long duration of disease (≥ 36 months) was an independent risk factor for poor surgical prognosis of patients after PFDD (OR = 21.948, 95%CI: 3.850-125.117; P = 0.001). Conclusions Long duration of disease is an independent risk factor for poor surgical prognosis in patients with CM1 complicated with syringomyelia treated by PFDD, and early surgical treatment is recommended for the patients with symptomatic CM1 complicated with syringomyelia.

Keywords

• arnold⁃chiari malformation
• syringomyelia
• neurosurgical procedures
• prognosis
• risk factors
• logistic models