For kids with Chiari type I malformation and syringomyelia, there was no significant difference in surgical complications whether they had decompression with or without duraplasty, a cluster-randomized controlled trial showed.The percentage of participants with complications within 6 months of surgery was 14% with posterior fossa decompression with duraplasty (PFD-D) and 6% with PFD alone.Many surgeons have "avoided what we perceive as the more effective operation, because of complications, and there doesn't seem to be a statistical difference," the lead researcher said.
For kids with Chiari type I malformation and syringomyelia, there was no significant difference in surgical complications whether they had decompression with or without duraplasty, a cluster-randomized controlled trial showed.
Complications within 6 months of surgery occurred in 14% of those who had posterior fossa decompression with duraplasty (PFD-D) and in 6% of those who had PFD alone (adjusted odds ratio 2.59, 95% CI 0.86 to 7.84, P=0.11), reported David Limbrick Jr., MD, PhD, of Virginia Commonwealth University School of Medicine in Richmond, and colleagues in the New England Journal of Medicine.
"There may be reasons to consider doing the PFD without duraplasty ... but the bottom line is that we've always avoided what we perceive as the more effective operation because of the complications, and there doesn't seem to be a statistical difference," Limbrick told MedPage Today.
