Authors
Shuai Yuan, Qi Yan, Renlong Chen, Jinglong Zhang, He Zhang, Ruobing Bai, Hang Yin, Zhiyong Zhao, Rong Xie
Published in
Journal of multidisciplinary healthcare. Volume 19. Pages 642693. Epub Oct 14, 2026.
Abstract
The optimal surgical strategy for patients with Chiari malformation type I (CMI) and syringomyelia remains debated, particularly regarding when additional craniovertebral junction (CVJ) stabilization is required in patients with anatomical abnormalities or suspected instability.
We performed a propensity score-matched retrospective analysis of 145 pairs (N=290) based on ten preoperative variables, including detailed CVJ morphometrics. The primary outcome was the 6-month neurological dysfunction score. Secondary outcomes included syrinx regression, operative metrics, and severe complications (ICU stay >24 h, prolonged ventilation, reintubation, or tracheotomy).
Both groups improved significantly neurologically at 6 months (2.0 ± 1.2 vs 2.1 ± 1.3; mean difference 0.1, 95% CI -0.3 to 0.5; p=0.638), with parallel recovery trajectories (time-by-strategy interaction p=0.582). Syrinx width reduction did not differ significantly between groups (-3.6 vs -2.9 mm, p=0.245). CVJ fixation-inclusive strategies were associated with longer operative duration (p<0.001), greater blood loss (p<0.001), and a higher observed frequency of severe complications (13.1% vs 0%; p<0.001).
In this propensity score-matched cohort, CVJ fixation-inclusive strategies were not associated with superior midterm neurological or radiographic outcomes compared with PFD alone after adjustment for measured baseline characteristics, while greater operative burden was observed in the fixation group. Residual confounding related to unmeasured dynamic instability cannot be excluded.
PMID:
42894790
Bibliographic data and abstract were imported from PubMed on 19 Oct 2026.
Read full publication at:
Please sign in
to see all details.
Advertisement
Stats
- Recommendations n/a n/a positive of 0 vote(s)
- Views 13
- Comments 0