Results of the surgical treatment in children with Chiari malformation type I

• Published in: Child's nervous system Vol. 35; no. 10; pp. 1911 - 1914
• Main Authors: Jarski, Paweł, Zimny, Mikołaj, Linart, Michał, Kozłowska, Zofia, Mandera, Marek
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2019
• Subjects: Medicine; Medicine & Public Health; Neurosciences; Neurosurgery; Special Annual Issue; Children; Chiari type 1; Surgical treatment; Chicago Chiari Outcome Scale; Quality of life
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-019-04247-4

Purpose Our study aimed to evaluate the quality of life of the patients operated due to Chiari malformation type 1 (CM-1) in the Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice. Methods We performed a retrospective analysis of 11 patients diagnosed with CM-1 who were treated in our center in the years 2007 to 2016. There were 6 female and 5 male individuals. Short-term evaluation of the outcome was based on comparison of the presenting symptoms and radiological images before and after the surgical treatment. Long-term follow-up was carried out using survey questionnaires based on the Chicago Chiari Outcome Scale (CCOS) devised originally by Aliaga et al. Results Patients, based on their CCOS score were divided into three groups marked as “improved,” “unchanged,” and “worse,” depending on a range of CCOS score: 13–16, 9–12, 4–8, respectively. The outcome of patients was as follows: 6 patients (55%) were evaluated as improved, and 5 (45%) as unchanged. No patient was classified as worse after surgery. Significant negative Spearman’s correlation was found between the CCOS score and patients’ age at the time of surgery ( R  = − 0.85, p  = 0.0009). Conclusions The decision of whether to operate pediatric patients with CM-1 should be considered very carefully. In our department, the main indication for surgery was the occurrence of clinical symptoms. Our study revealed that in the symptomatic patients, surgery improves their quality of life measured with CCOS.