Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 cases
Autor(a) principal: | |
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Data de Publicação: | 2004 |
Outros Autores: | , |
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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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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1818602529134477312 |