Background
The aim of this study was to compare the neurological outcomes and complication rates in surgically treated patients due to Chiari malformation type I depending upon the type of graft used for duroplasty.
Material and methods
We present a retrospective analysis of 85 patients treated for Chiari type I. Autologous grafts were used in 40 cases and non-autologous grafts in 45 cases. The long-term clinical outcomes were evaluated with the use of the Chicago Chiari Outcome Scale (CCOS).
Results
In the group with autologous grafts (AG), 28(70.0%) patients had significant improvement and stabilization of symptoms, while 12(30.0%) others deteriorated in the long term. In comparison with the non-autologus group (NG), the results were 35(77.8%) and 10(22.2%), respectively(p=0.46). Mean CCOS for the AG group was 12.27(functional outcome) and was comparable with the NG group (12.33). Excellent or functional outcome occurred in 27(67.5%) cases in the AG group and in 33(73.3%) in the NG group. Impaired or incapacitated outcome occurred in 13(32.5%) and 12(26.7%, p=0.64) cases, respectively. Complication rates in both groups were similar:7.5% in the AG group and 6.7% in the NG group(p=1). Six patients had complications, 4 of them (66.7%) required reoperation, 2 in each group (5.0% in the AG group vs 4.4% in the NG group, p=1). CSF-related complications (pseudomeningocele) occurred in 3 patients, including 1(2.0%) in the NG group and 2(5.0%, p=0.60) in the AG group (together with cerebellar subsidence in 1). In the remaining 3 patients, hematoma (2.2%) and purulent cutaneous fistula (2.2%) in the NA group and aseptic meningitis (2.5%) in the AG group were treated.
Conclusions
There are no significant differences in clinical outcomes and complication rates depending on the type of graft used for duroplasty in patients with Chiari type I malformation, and both autologous and non-autologous grafts can be safely used.