Predictors of reoperation for spinal disorders in Chiari malformation patients with prior surgical decompression
Background: Chiari malformation (CM) is a cluster of related developmental anomalies of the posterior fossa ranging from asymptomatic to fatal. Cranial and spinal decompression can help alleviate symptoms of increased cerebrospinal fluid pressure and correct spinal deformity. As surgical interventio...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
|
| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2023;volume=14;issue=4;spage=336;epage=340;aulast=Onafowokan |
| _version_ | 1797232745706946560 |
|---|---|
| author | Oluwatobi O Onafowokan Ankita Das Jamshaid M Mir Haddy Alas Tyler K Williamson Kimberly Mcfarland Jeffrey Varghese Sara Naessig Bailey Imbo Lara Passfall Oscar Krol Peter Tretiakov Rachel Joujon-Roche Pooja Dave Kevin Moattari Stephane Owusu-Sarpong Jordan Lebovic Shaleen Vira Bassel Diebo Virginie Lafage Peter Gust Passias |
| author_facet | Oluwatobi O Onafowokan Ankita Das Jamshaid M Mir Haddy Alas Tyler K Williamson Kimberly Mcfarland Jeffrey Varghese Sara Naessig Bailey Imbo Lara Passfall Oscar Krol Peter Tretiakov Rachel Joujon-Roche Pooja Dave Kevin Moattari Stephane Owusu-Sarpong Jordan Lebovic Shaleen Vira Bassel Diebo Virginie Lafage Peter Gust Passias |
| author_sort | Oluwatobi O Onafowokan |
| collection | DOAJ |
| description | Background: Chiari malformation (CM) is a cluster of related developmental anomalies of the posterior fossa ranging from asymptomatic to fatal. Cranial and spinal decompression can help alleviate symptoms of increased cerebrospinal fluid pressure and correct spinal deformity. As surgical intervention for CM increases in frequency, understanding predictors of reoperation may help optimize neurosurgical planning.
Materials and Methods: This was a retrospective analysis of the prospectively collected Healthcare Cost and Utilization Project's California State Inpatient Database years 2004–2011. Chiari malformation Types 1–4 (queried with ICD-9 CM codes) with associated spinal pathologies undergoing stand-alone spinal decompression (queried with ICD-9 CM procedure codes) were included. Cranial decompressions were excluded.
Results: One thousand four hundred and forty-six patients (29.28 years, 55.6% of females) were included. Fifty-eight patients (4.01%) required reoperation (67 reoperations). Patients aged 40–50 years had the most reoperations (11); however, patients aged 15–20 years had a significantly higher reoperation rate than all other groups (15.5% vs. 8.2%, P = 0.048). Female gender was significantly associated with reoperation (67.2% vs. 55.6%, P = 0.006). Medical comorbidities associated with reoperation included chronic lung disease (19% vs. 6.9%, P < 0.001), iron deficiency anemia (10.3% vs. 4.1%, P = 0.024), and renal failure (3.4% vs. 0.9%, P = 0.05). Associated significant cluster anomalies included spina bifida (48.3% vs. 34.8%, P = 0.035), tethered cord syndrome (6.9% vs. 2.1%, P = 0.015), syringomyelia (12.1% vs. 5.9%, P = 0.054), hydrocephalus (37.9% vs. 17.7%, P < 0.001), scoliosis (13.8% vs. 6.4%, P = 0.028), and ventricular septal defect (6.9% vs. 2.3%, P = 0.026).
Conclusions: Multiple medical and CM-specific comorbidities were associated with reoperation. Addressing them, where possible, may aid in improving CM surgery outcomes. |
| first_indexed | 2024-04-24T16:05:10Z |
| format | Article |
| id | doaj.art-5855f6219a304be29965dce4d9bd4600 |
| institution | Directory Open Access Journal |
| issn | 0974-8237 |
| language | English |
| last_indexed | 2024-04-24T16:05:10Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj.art-5855f6219a304be29965dce4d9bd46002024-04-01T05:54:48ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82372023-01-0114433634010.4103/jcvjs.jcvjs_140_23Predictors of reoperation for spinal disorders in Chiari malformation patients with prior surgical decompressionOluwatobi O OnafowokanAnkita DasJamshaid M MirHaddy AlasTyler K WilliamsonKimberly McfarlandJeffrey VargheseSara NaessigBailey ImboLara PassfallOscar KrolPeter TretiakovRachel Joujon-RochePooja DaveKevin MoattariStephane Owusu-SarpongJordan LebovicShaleen ViraBassel DieboVirginie LafagePeter Gust PassiasBackground: Chiari malformation (CM) is a cluster of related developmental anomalies of the posterior fossa ranging from asymptomatic to fatal. Cranial and spinal decompression can help alleviate symptoms of increased cerebrospinal fluid pressure and correct spinal deformity. As surgical intervention for CM increases in frequency, understanding predictors of reoperation may help optimize neurosurgical planning. Materials and Methods: This was a retrospective analysis of the prospectively collected Healthcare Cost and Utilization Project's California State Inpatient Database years 2004–2011. Chiari malformation Types 1–4 (queried with ICD-9 CM codes) with associated spinal pathologies undergoing stand-alone spinal decompression (queried with ICD-9 CM procedure codes) were included. Cranial decompressions were excluded. Results: One thousand four hundred and forty-six patients (29.28 years, 55.6% of females) were included. Fifty-eight patients (4.01%) required reoperation (67 reoperations). Patients aged 40–50 years had the most reoperations (11); however, patients aged 15–20 years had a significantly higher reoperation rate than all other groups (15.5% vs. 8.2%, P = 0.048). Female gender was significantly associated with reoperation (67.2% vs. 55.6%, P = 0.006). Medical comorbidities associated with reoperation included chronic lung disease (19% vs. 6.9%, P < 0.001), iron deficiency anemia (10.3% vs. 4.1%, P = 0.024), and renal failure (3.4% vs. 0.9%, P = 0.05). Associated significant cluster anomalies included spina bifida (48.3% vs. 34.8%, P = 0.035), tethered cord syndrome (6.9% vs. 2.1%, P = 0.015), syringomyelia (12.1% vs. 5.9%, P = 0.054), hydrocephalus (37.9% vs. 17.7%, P < 0.001), scoliosis (13.8% vs. 6.4%, P = 0.028), and ventricular septal defect (6.9% vs. 2.3%, P = 0.026). Conclusions: Multiple medical and CM-specific comorbidities were associated with reoperation. Addressing them, where possible, may aid in improving CM surgery outcomes.http://www.jcvjs.com/article.asp?issn=0974-8237;year=2023;volume=14;issue=4;spage=336;epage=340;aulast=Onafowokanchiari malformationdecompressionpredictorsreoperation |
| spellingShingle | Oluwatobi O Onafowokan Ankita Das Jamshaid M Mir Haddy Alas Tyler K Williamson Kimberly Mcfarland Jeffrey Varghese Sara Naessig Bailey Imbo Lara Passfall Oscar Krol Peter Tretiakov Rachel Joujon-Roche Pooja Dave Kevin Moattari Stephane Owusu-Sarpong Jordan Lebovic Shaleen Vira Bassel Diebo Virginie Lafage Peter Gust Passias Predictors of reoperation for spinal disorders in Chiari malformation patients with prior surgical decompression Journal of Craniovertebral Junction and Spine chiari malformation decompression predictors reoperation |
| title | Predictors of reoperation for spinal disorders in Chiari malformation patients with prior surgical decompression |
| title_full | Predictors of reoperation for spinal disorders in Chiari malformation patients with prior surgical decompression |
| title_fullStr | Predictors of reoperation for spinal disorders in Chiari malformation patients with prior surgical decompression |
| title_full_unstemmed | Predictors of reoperation for spinal disorders in Chiari malformation patients with prior surgical decompression |
| title_short | Predictors of reoperation for spinal disorders in Chiari malformation patients with prior surgical decompression |
| title_sort | predictors of reoperation for spinal disorders in chiari malformation patients with prior surgical decompression |
| topic | chiari malformation decompression predictors reoperation |
| url | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2023;volume=14;issue=4;spage=336;epage=340;aulast=Onafowokan |
| work_keys_str_mv | AT oluwatobioonafowokan predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT ankitadas predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT jamshaidmmir predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT haddyalas predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT tylerkwilliamson predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT kimberlymcfarland predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT jeffreyvarghese predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT saranaessig predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT baileyimbo predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT larapassfall predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT oscarkrol predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT petertretiakov predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT racheljoujonroche predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT poojadave predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT kevinmoattari predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT stephaneowususarpong predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT jordanlebovic predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT shaleenvira predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT basseldiebo predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT virginielafage predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression AT petergustpassias predictorsofreoperationforspinaldisordersinchiarimalformationpatientswithpriorsurgicaldecompression |