000			03689nam a22005417a 4500
008			220316s20222022 xxu||||| |||| 00| 0 eng d
022			_a1878-8750
024			_a10.1016/j.wneu.2022.02.068 [doi]
024			_aS1878-8750(22)00215-7 [pii]
040			_aOvid MEDLINE(R)
099			_a35192974
245			_aCraniocervical Stabilization after Failed Chiari Decompression: A Case Series of a Population with High Prevalence of Ehlers-Danlos Syndrome.
245			_aCraniocervical Stabilization After Failed Chiari Decompression: A Case Series of a Population with High Prevalence of Ehlers-Danlos Syndrome.
251			_aWorld Neurosurgery. 161:e546-e552, 2022 May.
252			_aWorld Neurosurg. 161:e546-e552, 2022 May.
252			_zWorld Neurosurg. 2022 Feb 19
253			_aWorld neurosurgery
260			_c2022
260			_fFY2022
260			_p2022 Feb 19
265			_sppublish
266			_d2022-03-17
268			_aWorld Neurosurgery. 2022 Feb 19
520			_aBACKGROUND: In the treatment of Chiari malformation Type I (CM-I), posterior fossa decompression is achieved via suboccipital craniectomy (SOC); however, some patients continue to experience symptoms after treatment which may be due to craniocervical instability (CCI). The purposes of this study were to analyze data from patients who required an occipitocervical fusion (OCF) for the management of CCI after having previously undergone SOC for CM-I to determine if OCF is a safe and effective option and to determine any identifiable risk factors for CCI in these patients.
520			_aCONCLUSIONS: Symptomatic CCI should be recognized as a delayed postoperative complication in the surgical treatment of CM-I, with an underlying connective tissue hypermobility disorder such as EDS serving as a potential risk factor its development. CCI can be managed with OCF as a safe and effective treatment option for this patient population. Copyright ♭ 2022 Elsevier Inc. All rights reserved.
520			_aMETHODS: A retrospective review was done on all patients who underwent an occipitocervical fusion (OCF) performed by the senior author between November 2013 and June 2020 after having previously undergone SOC for CM-I. Demographic, radiographic, perioperative, and outcome data were collected and clivoaxial angles (CXA) were measured pre- and post-operatively.
520			_aRESULTS: Fifteen patients were identified who developed symptomatic CCI after previously undergoing a suboccipital craniectomy for the treatment of CM-I. All 15 patients were treated by OCF with good outcome. Of these, 12 patients had a known diagnosis of Ehlers-Danlos Syndrome (EDS). Overall, the CXAs of these patients were found to be corrected to a more anatomical alignment.
546			_aEnglish
650			_a*Arnold-Chiari Malformation
650			_a*Ehlers-Danlos Syndrome
650			_aArnold-Chiari Malformation/dg [Diagnostic Imaging]
650			_aArnold-Chiari Malformation/ep [Epidemiology]
650			_aArnold-Chiari Malformation/su [Surgery]
650			_aDecompression
650			_aEhlers-Danlos Syndrome/co [Complications]
650			_aEhlers-Danlos Syndrome/ep [Epidemiology]
650			_aEhlers-Danlos Syndrome/su [Surgery]
650			_aHumans
650			_aPrevalence
650			_aResearch
656			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
656			_aNeurosurgery Residency
657			_aJournal Article
700			_aZhao, David
790			_aRock MB, Sandhu FA, Zhao DY
856			_uhttps://dx.doi.org/10.1016/j.wneu.2022.02.068 _zhttps://dx.doi.org/10.1016/j.wneu.2022.02.068
942			_cART _dArticle
999			_c714 _d714