Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 cases

Detalhes bibliográficos
Autor(a) principal: Arruda, José Arnaldo Motta de
Data de Publicação: 2004
Outros Autores: Costa, Carlos Maurício de Castro, Tella Jr, Oswaldo Inácio de [UNIFESP]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNIFESP
dARK ID: ark:/48912/001300000wjrt
Texto Completo: http://dx.doi.org/10.1590/S0004-282X2004000200009
http://repositorio.unifesp.br/handle/11600/2094
Resumo: We analyze the results of surgical treatment of 60 patients presenting syringomyelia (SM) associated with Chiari malformation (CM) who were operated in the period 1982-2000. For each case, analysis covered 15 signs and 16 symptoms included in a protocol that separated SM signs and symptoms from those of CM. A score system was established in parallel with the protocol to make the evaluation of treatment results easier. All cases were submitted to craniovertebral decompression by C1 and eventually C2 laminectomy and cerebellar tonsillectomy with duramater graft. To evaluate the results, statistical proportion difference tests and variance analyses were made to a reliability index of 95% (p=0.05). We conclude that the statistical improvement of CM signs and symptoms was very significant (p=0). Syringomyelia signs and symptoms also improved significantly, except for upper limb hyporeflexia , which did not improve. No statistical difference in the improvement of SM symptoms as compared to CM symptom was found. Syringomyelia signs improved statistically more than CM signs. In half of patients, the percent improvement of signs and symptoms ranged between 40% and 60%.
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spelling Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 casesResultados do tratamento da siringomielia associada com malformação de Chiari: análise de 60 casossyringomyeliaChiari malformationsurgical treatmentsiringomieliamalformação de Chiaritratamento cirúrgicoWe analyze the results of surgical treatment of 60 patients presenting syringomyelia (SM) associated with Chiari malformation (CM) who were operated in the period 1982-2000. For each case, analysis covered 15 signs and 16 symptoms included in a protocol that separated SM signs and symptoms from those of CM. A score system was established in parallel with the protocol to make the evaluation of treatment results easier. All cases were submitted to craniovertebral decompression by C1 and eventually C2 laminectomy and cerebellar tonsillectomy with duramater graft. To evaluate the results, statistical proportion difference tests and variance analyses were made to a reliability index of 95% (p=0.05). We conclude that the statistical improvement of CM signs and symptoms was very significant (p=0). Syringomyelia signs and symptoms also improved significantly, except for upper limb hyporeflexia , which did not improve. No statistical difference in the improvement of SM symptoms as compared to CM symptom was found. Syringomyelia signs improved statistically more than CM signs. In half of patients, the percent improvement of signs and symptoms ranged between 40% and 60%.RESUMO Analisamos os resultados do tratamento cirúrgico de 60 pacientes com a associação de siringomielia (SM) e malformação de Chiari (MC) operados no período de 1982 a 2000. Em cada caso foram analisados 15 sinais e 16 sintomas, incluídos em um protocolo que separou os sinais e sintomas decorrentes da SM dos sinais e sintomas decorrentes da MC. Paralelamente ao protocolo, foi elaborado um sistema de pontuação que facilitou a avaliação dos resultados do tratamento. Todos os casos foram submetidos à descompressão crânio vertebral com laminectomia de C1 e eventualmente de C2, e tonsilectomia cerebelar com plástica de dura-máter. Para avaliação dos resultados, foram aplicados testes estatísticos de diferença de proporções e análise de variância com confiabilidade de 95% (p=0,05). Concluímos que os sinais e sintomas da MC apresentaram melhora estatística muito significativa (p=0). Os sinais e sintomas decorrentes da SM também apresentaram melhora significativa, sendo a exceção o sinal hiporreflexia de membros superiores que não melhorou. Não encontrada diferença estatística da melhora dos sintomas da SM quando comparados aos da MC. Os sinais na SM melhoraram estatisticamente mais que os sinais da MC. A metade dos pacientes apresentou percentual de melhora de seus sinais e sintomas na faixa entre 40 e 60%.Universidade Federal do Ceará Hospital Universitário Walter Cantídio Serviço de NeurologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciELOAcademia Brasileira de Neurologia - ABNEUROUniversidade Federal do Ceará Hospital Universitário Walter Cantídio Serviço de NeurologiaUniversidade Federal de São Paulo (UNIFESP)Arruda, José Arnaldo Motta deCosta, Carlos Maurício de CastroTella Jr, Oswaldo Inácio de [UNIFESP]2015-06-14T13:30:23Z2015-06-14T13:30:23Z2004-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion237-244application/pdfhttp://dx.doi.org/10.1590/S0004-282X2004000200009Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 62, n. 2a, p. 237-244, 2004.10.1590/S0004-282X2004000200009S0004-282X2004000200009.pdf0004-282XS0004-282X2004000200009http://repositorio.unifesp.br/handle/11600/2094WOS:000221709400009ark:/48912/001300000wjrtengArquivos de Neuro-Psiquiatriainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-28T06:59:41Zoai:repositorio.unifesp.br/:11600/2094Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-12-11T20:41:36.097726Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 cases
Resultados do tratamento da siringomielia associada com malformação de Chiari: análise de 60 casos
title Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 cases
spellingShingle Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 cases
Arruda, José Arnaldo Motta de
syringomyelia
Chiari malformation
surgical treatment
siringomielia
malformação de Chiari
tratamento cirúrgico
title_short Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 cases
title_full Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 cases
title_fullStr Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 cases
title_full_unstemmed Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 cases
title_sort Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 cases
author Arruda, José Arnaldo Motta de
author_facet Arruda, José Arnaldo Motta de
Costa, Carlos Maurício de Castro
Tella Jr, Oswaldo Inácio de [UNIFESP]
author_role author
author2 Costa, Carlos Maurício de Castro
Tella Jr, Oswaldo Inácio de [UNIFESP]
author2_role author
author
dc.contributor.none.fl_str_mv Universidade Federal do Ceará Hospital Universitário Walter Cantídio Serviço de Neurologia
Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Arruda, José Arnaldo Motta de
Costa, Carlos Maurício de Castro
Tella Jr, Oswaldo Inácio de [UNIFESP]
dc.subject.por.fl_str_mv syringomyelia
Chiari malformation
surgical treatment
siringomielia
malformação de Chiari
tratamento cirúrgico
topic syringomyelia
Chiari malformation
surgical treatment
siringomielia
malformação de Chiari
tratamento cirúrgico
description We analyze the results of surgical treatment of 60 patients presenting syringomyelia (SM) associated with Chiari malformation (CM) who were operated in the period 1982-2000. For each case, analysis covered 15 signs and 16 symptoms included in a protocol that separated SM signs and symptoms from those of CM. A score system was established in parallel with the protocol to make the evaluation of treatment results easier. All cases were submitted to craniovertebral decompression by C1 and eventually C2 laminectomy and cerebellar tonsillectomy with duramater graft. To evaluate the results, statistical proportion difference tests and variance analyses were made to a reliability index of 95% (p=0.05). We conclude that the statistical improvement of CM signs and symptoms was very significant (p=0). Syringomyelia signs and symptoms also improved significantly, except for upper limb hyporeflexia , which did not improve. No statistical difference in the improvement of SM symptoms as compared to CM symptom was found. Syringomyelia signs improved statistically more than CM signs. In half of patients, the percent improvement of signs and symptoms ranged between 40% and 60%.
publishDate 2004
dc.date.none.fl_str_mv 2004-06-01
2015-06-14T13:30:23Z
2015-06-14T13:30:23Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1590/S0004-282X2004000200009
Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 62, n. 2a, p. 237-244, 2004.
10.1590/S0004-282X2004000200009
S0004-282X2004000200009.pdf
0004-282X
S0004-282X2004000200009
http://repositorio.unifesp.br/handle/11600/2094
WOS:000221709400009
dc.identifier.dark.fl_str_mv ark:/48912/001300000wjrt
url http://dx.doi.org/10.1590/S0004-282X2004000200009
http://repositorio.unifesp.br/handle/11600/2094
identifier_str_mv Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 62, n. 2a, p. 237-244, 2004.
10.1590/S0004-282X2004000200009
S0004-282X2004000200009.pdf
0004-282X
S0004-282X2004000200009
WOS:000221709400009
ark:/48912/001300000wjrt
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Arquivos de Neuro-Psiquiatria
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 237-244
application/pdf
dc.publisher.none.fl_str_mv Academia Brasileira de Neurologia - ABNEURO
publisher.none.fl_str_mv Academia Brasileira de Neurologia - ABNEURO
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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