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ORIGINAL ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 4  |  Page : 145-149

Morphometric factors affecting functional outcome in symptomatic Chiari I malformation and syrinx


1 Assistant Professor, Department of Neurosurgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
2 Additional Professor, Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
3 Professor, Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
4 Professor, Department of Neuroimaging and Interventional Neuroradiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India

Correspondence Address:
B Indira Devi
Professor, Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10039-1149

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Objective: To find out the morphometric factors predicting outcome in Chiari I malformation (CM I) associated with syringomyelia. Materials and methods: In a series of 73 patients with CM I and syrinx who underwent posterior fossa decompression (PFD) between August 2013 and October 2015, a total of 54 subjects with sufficient clinical data and imaging suitable for morphometric measurments were evaluated. The parameters analyzed were posterior fossa volume (PFV), tonsillar descent (TD), foramen magnum (FM) diameter, supra-occiput length, clival length, the syrinx, and cord diameter. Patients were divided into two groups: With or without improvement. Improvement at follow-up was assessed with the Chicago Chiari Outcome Scale (CCOS). Results: Mean PFV was significantly higher in the improvement group (219.90 ± 30.20 vs 187.95 ± 12.51 cm3, p = 0.047). Syrinx to cord ratio was lower in the improved group (0.54 ± 0.21 vs 0.64 ± 0.27, p = 0.081). The cut-off value of preoperative PFV for prediction of improvement was found to be 198.58 cm3 (sensitivity 77.8%, specificity 100%). Conclusion: To the best of our knowledge, this is the largest series to evaluate the role of morphometry in prediction of surgical outcome in patients with CM I associated with syringomyelia. The PFV is the only radiological factor that differs significantly in patients with and without improvement.


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