Abstract
Background:Pseudomeningocele is a known operative complication of Chiari decompression with significant morbidity.Methods:A retrospective analysis of 150 consecutive patients from November 1991 to June 2011 was conducted. Symptomatic pseudomeningocele was defined clinically; to meet definition it must have required operative intervention. Variables evaluated included sex, age, use of graft, and use of operative sealant. The Chi-square, Fisher test, and the two-sample t-test were used as appropriate to determine significance. Multiple logistic regression was used to determine independent risk factors for complication.Results:A total of 67.3% of patients were female, with average age being 39.7 years. A total of 67.3% of patients had a graft placed with the most common being fascia lata. Only nine patients (6%) presented with pseudomeningocele. Factors observed to be significantly associated with pseudomeningocele development were age and use of sealant. Age and sealant use were also independent risk factors for complication. Adjusted for the significant effect of age, odds for complication among patients with sealant usage were 6.67 times those for patients without sealant. Adjusted for the significance of sealant usage, there is a 6% increase in odds for complication for every year increase in patient's age.Conclusions:A statistically significant relationship exists between age and sealant use and the risk of developing a postoperative pseudomeningocele. Emphasis and attention must be placed on meticulous closure technique. This information can aide in preoperative planning and patient selection.
Highlights
Pseudomeningocele is a known operative complication of Chiari decompression with significant morbidity
Chiari malformations represent a broad group of craniovertebral anomalies in which patients may present in a spectrum of different clinical scenarios.[17,21,22]
Chiari is traditionally defined as an extension of the cerebellar tonsils through the foramen magnum, with distance required for radiographic diagnosis variable with age.[4,5]
Summary
A retrospective analysis of 150 consecutive patients from November 1991 to June 2011 was conducted. Multiple logistic regression was used to determine independent risk factors for complication. A retrospective analysis of patient charts, operative records, and radiology reports was performed upon consecutive patients undergoing operative intervention for Chiari malformation at our institution from April 1991 to June 2011. This was performed using the historical database available for all surgical patients created by the Department of Neurosurgery. Inclusion criteria included patients undergoing a first time decompression via sub‐occipital craniectomy for Chiari malformation This was limited to type I Chiari malformations as linked with the admission or surgical diagnosis. Other complications were not considered in the aim of this study
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