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).
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.
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.