Duraplasty sort as a predictor of meningitis and shunting following Chiari I decompression.
World Neurosurg. 2018 Jul 16;:
Authors: Farber SH, McDowell MM, Alhourani A, Agarwal N, Friedlander RM
INTRODUCTION: Expansile duraplasty is regularly carried out throughout Chiari I decompression. Aseptic and bacterial meningitis are potential issues of this process. We sought to check the charges of meningitis and subsequent want for CSF diversion with duraplasty using bovine pericardial (BPC) xenograft and allograft.
METHODS: We carried out a retrospective assessment of 112 sufferers who underwent Chiari I decompression. All sufferers underwent duraplasty with both allograft or BPC. Incidence of post-operative lumbar punctures and related information have been recorded to find out charges of meningitis. Charges of subsequent shunting have been additionally recorded.
RESULTS: General, 112 sufferers have been included within the research; 30 that underwent duraplasty with allograft (27%) and 82 that obtained BPC (73%). A complete of 26 sufferers developed post-operative meningitis (23 circumstances of chemical meningitis and three of bacterial meningitis). Charges of all meningitis have been greater in sufferers who obtained BPC in comparison with sufferers who obtained allograft (28% vs. 10%; p = zero.047). The speed of shunting was larger in sufferers with meningitis in comparison with non-meningitic sufferers (56.5% vs. 5.75%; p <zero.0001). Furthermore, 13 of the 15 sufferers (87%) within the BPC cohort who have been shunted have been discovered to have meningitis in comparison with zero of the three shunted sufferers (zero%) within the allograft cohort (p = zero.044).
CONCLUSIONS: We discovered that charges of whole meningitis have been larger in sufferers who underwent Chiari I decompression and duraplasty with BPC in comparison with an allograft. The speed of shunting was considerably greater for sufferers who developed meningitis following decompression in comparison with non-meningitic sufferers.
PMID: 30026145 [PubMed – as supplied by publisher]