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  1. Article: Clinical and Radiological Outcomes of Dura-Splitting versus Duraplasty Techniques in Pediatric Chiari I Malformation: A Systematic Review and Meta-Analysis.

    Tavallaii, Amin / Keykhosravi, Ehsan / Ghorbanpour, Ahmad / Shahriari, Ali / Rezaee, Hamid

    Asian journal of neurosurgery

    2023  Volume 18, Issue 3, Page(s) 423–436

    Abstract: Type I Chiari malformation is a developmental anomaly with various proposed surgical techniques for its management. The dura-splitting technique is a less invasive approach and involves the resection of the outer layer of the dura while sparing the ... ...

    Abstract Type I Chiari malformation is a developmental anomaly with various proposed surgical techniques for its management. The dura-splitting technique is a less invasive approach and involves the resection of the outer layer of the dura while sparing the internal layer. While this less-known approach may minimize the complication rates, there are concerns about its efficacy and outcome. Therefore, we have performed a systematic review and meta-analysis of available data on clinical and radiological outcomes of this technique in the pediatric population and compared them to the foramen magnum decompression and duraplasty technique. We have followed the Meta-analysis Of Observational Studies in Epidemiology guidelines in this review. Based on our predefined search strategy, we performed a systematic database search. Subsequently, the article screening process was done based on defined inclusion/exclusion criteria. Following the quality assessment of included studies, two authors performed data extraction. Finally, the extracted data were summarized and presented in form of tables. Forest plots were used to demonstrate the results of the meta-analysis. A review of 8 included studies consisting of 615 patients revealed the significant advantage of the dura-splitting technique in terms of shorter operation duration and hospital stay. The recurrence rate and clinical and radiological outcomes were almost similar between the two surgical techniques. Complication rates were significantly lower in the dura-splitting technique. Dura-splitting can be an effective and safe approach for the management of pediatric Chiari I malformation. However, these results are mostly extracted from observational studies and future randomized controlled trials are recommended.
    Language English
    Publishing date 2023-05-01
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 2621446-5
    ISSN 2248-9614 ; 1793-5482
    ISSN (online) 2248-9614
    ISSN 1793-5482
    DOI 10.1055/s-0043-1764324
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Clinical and Radiological Outcomes of Dura-Splitting versus Duraplasty Techniques in Pediatric Chiari I Malformation: A Systematic Review and Meta-Analysis

    Tavallaii, Amin / Keykhosravi, Ehsan / Ghorbanpour, Ahmad / Shahriari, Ali / Rezaee, Hamid

    Asian Journal of Neurosurgery

    2023  Volume 18, Issue 03, Page(s) 423–436

    Abstract: Type I Chiari malformation is a developmental anomaly with various proposed surgical techniques for its management. The dura-splitting technique is a less invasive approach and involves the resection of the outer layer of the dura while sparing the ... ...

    Abstract Type I Chiari malformation is a developmental anomaly with various proposed surgical techniques for its management. The dura-splitting technique is a less invasive approach and involves the resection of the outer layer of the dura while sparing the internal layer. While this less-known approach may minimize the complication rates, there are concerns about its efficacy and outcome. Therefore, we have performed a systematic review and meta-analysis of available data on clinical and radiological outcomes of this technique in the pediatric population and compared them to the foramen magnum decompression and duraplasty technique. We have followed the Meta-analysis Of Observational Studies in Epidemiology guidelines in this review. Based on our predefined search strategy, we performed a systematic database search. Subsequently, the article screening process was done based on defined inclusion/exclusion criteria. Following the quality assessment of included studies, two authors performed data extraction. Finally, the extracted data were summarized and presented in form of tables. Forest plots were used to demonstrate the results of the meta-analysis. A review of 8 included studies consisting of 615 patients revealed the significant advantage of the dura-splitting technique in terms of shorter operation duration and hospital stay. The recurrence rate and clinical and radiological outcomes were almost similar between the two surgical techniques. Complication rates were significantly lower in the dura-splitting technique. Dura-splitting can be an effective and safe approach for the management of pediatric Chiari I malformation. However, these results are mostly extracted from observational studies and future randomized controlled trials are recommended.
    Keywords Chiari malformation type I ; dura-splitting ; duraplasty ; outcome ; pediatric
    Language English
    Publishing date 2023-05-01
    Publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2621446-5
    ISSN 2248-9614 ; 1793-5482 ; 2248-9614
    ISSN (online) 2248-9614
    ISSN 1793-5482 ; 2248-9614
    DOI 10.1055/s-0043-1764324
    Database Thieme publisher's database

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  3. Article ; Online: Outcomes of dura-splitting technique compared to conventional duraplasty technique in the treatment of adult Chiari I malformation: a systematic review and meta-analysis.

    Tavallaii, Amin / Keykhosravi, Ehsan / Rezaee, Hamid / Abouei Mehrizi, Mohammad Ali / Ghorbanpour, Ahmad / Shahriari, Ali

    Neurosurgical review

    2020  Volume 44, Issue 3, Page(s) 1313–1329

    Abstract: Chiari malformation type I is a developmental abnormality with an array of surgical techniques introduced for the management of it. The most common technique is foramen magnum decompression with duraplasty. Dura-splitting technique as one of the non-dura- ...

    Abstract Chiari malformation type I is a developmental abnormality with an array of surgical techniques introduced for the management of it. The most common technique is foramen magnum decompression with duraplasty. Dura-splitting technique as one of the non-dura-opening techniques is a less known procedure that spares the internal layer of the dura and can theoretically result in fewer complications compared to duraplasty. So, we performed a review of literature and meta-analysis on different clinical and radiological aspects of this technique and compared its outcomes to duraplasty. MOOSE guidelines were followed. A systematic search of three databases based on predefined search strategy and inclusion/exclusion criteria was performed. After quality assessment and data extraction by two authors, summarized data were presented in form of tables, and meta-analysis results were illustrated in forest plots. A review of 10 included studies consisting of 370 patients revealed significantly shorter operation duration and less intraoperative blood loss in the dura-splitting technique compared to duraplasty. Interestingly, there was no significant difference between these two techniques in terms of clinical and radiological outcomes. Overall complication rate and incidence of CSF-related complications or infections were significantly in favor of the dura-splitting technique. Dura-splitting technique can be considered as a safe and effective surgical procedure for Chiari I malformation with comparable outcomes and fewer complications compared to duraplasty, although this interpretation is derived from retrospective observational studies and lack of a prospective clinical trial is evident.
    MeSH term(s) Arnold-Chiari Malformation/diagnostic imaging ; Arnold-Chiari Malformation/surgery ; Blood Loss, Surgical/prevention & control ; Databases, Factual/trends ; Decompression, Surgical/methods ; Decompression, Surgical/trends ; Dura Mater/diagnostic imaging ; Dura Mater/surgery ; Foramen Magnum/diagnostic imaging ; Foramen Magnum/surgery ; Humans ; Observational Studies as Topic/methods ; Reconstructive Surgical Procedures/methods ; Reconstructive Surgical Procedures/trends ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2020-06-22
    Publishing country Germany
    Document type Comparative Study ; Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 6907-3
    ISSN 1437-2320 ; 0344-5607
    ISSN (online) 1437-2320
    ISSN 0344-5607
    DOI 10.1007/s10143-020-01334-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: In Reply to the Letter to the Editor Regarding "Rate and Risk Factors of Early Ventriculoperitoneal Shunt Revision: A Five-Year Retrospective Analysis of a Referral Center".

    Zabihyan, Samira / Dayyani, Mojtaba / Ahmadvand, Saba / Etemadrezaie, Hamid / Ghorbanpour, Ahmad / Zarei, Reyhaneh / Shahriyari, Ali / Emadzadeh, Maryam / Ganjeifar, Babak

    World neurosurgery

    2020  Volume 135, Page(s) 395

    MeSH term(s) Humans ; Hydrocephalus/surgery ; Referral and Consultation ; Reoperation ; Retrospective Studies ; Risk Factors ; Ventriculoperitoneal Shunt
    Language English
    Publishing date 2020-03-03
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2019.12.120
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Rate and Risk Factors of Early Ventriculoperitoneal Shunt Revision: A Five-Year Retrospective Analysis of a Referral Center.

    Ahmadvand, Saba / Dayyani, Mojtaba / Etemadrezaie, Hamid / Ghorbanpour, Ahmad / Zarei, Reyhaneh / Shahriyari, Ali / Emadzadeh, Maryam / Ganjeifar, Babak / Zabihyan, Samira

    World neurosurgery

    2019  Volume 134, Page(s) e505–e511

    Abstract: Background: Cerebral shunts are the mainstay treatment of hydrocephalus. Because most previous studies have focused on factors related to long-term outcomes of shunt surgery, we aimed to assess the rates and causes of 30-day ventriculoperitoneal shunt ( ... ...

    Abstract Background: Cerebral shunts are the mainstay treatment of hydrocephalus. Because most previous studies have focused on factors related to long-term outcomes of shunt surgery, we aimed to assess the rates and causes of 30-day ventriculoperitoneal shunt (VPS) failure in a single referral center over 5 years in both adult and pediatric patients.
    Methods: Patients who underwent VPS surgery from February 2012 to February 2017 in Ghaem Teaching Hospital, Mashhad, Iran were evaluated retrospectively through clinical history, operative reports, imaging studies, and follow-up notes. Data of 12 possible factors related to shunt failure were collected comprising age, gender, household income, level of education, cause of hydrocephalus, causes of revision, type of failure, anatomic site, duration of operation, time of surgery, surgeons' level of expertise, and Glasgow Coma Scale (GCS) score.
    Results: Among 403 VPS placements, 121 VPS revisions were performed, and 82 eligible patients were included in the study (57.3% male and 42.7% female). The 30-day shunt failure rate was 24.4% among all revisions. Obstruction and malposition were the most common causes of early revisions. Six factors were statistically significant in the univariate analysis. After adjustment in a logistic regression model, 2 factors, namely surgeons' level of expertise (odds ratio, 10.33; 95% confidence interval, 1.08-98.80) and anatomic site of the shunt (odds ratio, 10.28; 95% confidence interval, 1.21-87.35) were associated with early shunt revision.
    Conclusions: Shunt surgeries performed by junior residents and shunts placed in the frontal site were associated with early shunt failure.
    MeSH term(s) Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cross-Sectional Studies ; Equipment Failure ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Middle Aged ; Referral and Consultation ; Reoperation ; Retrospective Studies ; Risk Factors ; Ventriculoperitoneal Shunt ; Young Adult
    Language English
    Publishing date 2019-11-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2019.10.108
    Database MEDical Literature Analysis and Retrieval System OnLINE

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