Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich.
mehr Informationen...
Posterior fossa decompression with or without duraplasty for patients with chiari type I malformation and basilar impression: a meta-analysis
Ist Teil von
European spine journal, 2021-02, Vol.30 (2), p.454-460
Ort / Verlag
Berlin/Heidelberg: Springer Berlin Heidelberg
Erscheinungsjahr
2021
Link zum Volltext
Quelle
SpringerNature Journals
Beschreibungen/Notizen
Background
To compare clinical effect and safety between posterior fossa decompression with duraplasty (PFDD) and posterior fossa decompression without duraplasty (PFD) in treatment of Chiari type I malformation and basilar impression.
Methods
A comprehensive computer search was conducted from 2000 to 2019. The quality assessment was performed by the QUADAS-2 tool. The clinical value of comparison between PFDD and PFD was evaluated by using the pooled estimate of sensitivity and specificity. In addition, sensitivity analysis and bias analysis were applied to ensure the accuracy of the results.
Results
Finally, 468 patients were enrolled in 6 studies and ultimately met the eligibility criteria. The PFDD and PFD groups were 282 and 186, respectively. The meta-analysis showed no significant difference in the Chicago Chiari Outcome Scale (COSS score) (MD = 0.14, 95% CI [−0.23, 0.50],
P
= 0.47;
P
= heterogeneity = 0.86,
I
2
= 0%). Meanwhile, Significant difference existed in length of stay (MD = −1.08, 95% CI [−1.32, −0.84],
P
= 0.001; heterogeneity
P
< 0.000001,
I
2
= 85%) and complications (OR = 0.35, 95%CI [0.20, 0.62],
P
= 0.0003;
P
for Heterogeneity = 0.04,
I
2
= 56%).
Conclusion
PFD is a more efficient and safer therapy than PFDD in the treatment of Chiari type I malformation with basilar impression.