{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T01:14:08Z","timestamp":1783386848652,"version":"3.54.6"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Childs Nerv Syst"],"DOI":"10.1007\/s00381-026-07388-5","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:31:36Z","timestamp":1783384296000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cervicomedullary CSF space obliteration as a risk factor of reoperation in Chiari malformation type I"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5989-3064","authenticated-orcid":false,"given":"Aaron M.","family":"Yengo-Kahn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando Cotrim","family":"Gomes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel A.","family":"Tenhoeve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"Self","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"Mesina-Estarr\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Gramer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Kurudza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Ludwick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas L.","family":"Brockmeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"7388_CR1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l1159","volume":"365","author":"RJ Piper","year":"2019","unstructured":"Piper RJ, Pike M, Harrington R, Magdum SA (2019) Chiari malformations: principles of diagnosis and management. BMJ 365:l1159. https:\/\/doi.org\/10.1136\/bmj.l1159","journal-title":"BMJ"},{"key":"7388_CR2","doi-asserted-by":"publisher","first-page":"920","DOI":"10.3171\/jns.2000.92.6.0920","volume":"92","author":"J Meadows","year":"2000","unstructured":"Meadows J, Kraut M, Guarnieri M et al (2000) Asymptomatic Chiari type I malformations identified on magnetic resonance imaging. J Neurosurg 92:920\u2013926. https:\/\/doi.org\/10.3171\/jns.2000.92.6.0920","journal-title":"J Neurosurg"},{"key":"7388_CR3","doi-asserted-by":"publisher","DOI":"10.3171\/2011.8.FOCUS11195","author":"MR Proctor","year":"2011","unstructured":"Proctor MR, Scott RM, Oakes WJ, Muraszko KM (2011) Chiari malformation. Neurosurg Focus. https:\/\/doi.org\/10.3171\/2011.8.FOCUS11195","journal-title":"Neurosurg Focus"},{"key":"7388_CR4","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.ncl.2021.11.007","volume":"40","author":"JS Rosenblum","year":"2022","unstructured":"Rosenblum JS, Pomeraniec IJ, Heiss JD (2022) Chiari malformation (update on diagnosis and treatment). Neurol Clin 40:297\u2013307. https:\/\/doi.org\/10.1016\/j.ncl.2021.11.007","journal-title":"Neurol Clin"},{"key":"7388_CR5","doi-asserted-by":"publisher","first-page":"205","DOI":"10.3171\/2011.5.PEDS1121","volume":"8","author":"J Strahle","year":"2011","unstructured":"Strahle J, Muraszko KM, Kapurch J et al (2011) Chiari malformation type I and syrinx in children undergoing magnetic resonance imaging: clinical article. J Neurosurg Pediatr 8:205\u2013213. https:\/\/doi.org\/10.3171\/2011.5.PEDS1121","journal-title":"J Neurosurg Pediatr"},{"key":"7388_CR6","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.clineuro.2018.09.016","volume":"174","author":"E Doruk","year":"2018","unstructured":"Doruk E, Ozay R, Sekerci Z et al (2018) Cervico-medullary compression ratio: a novel radiological parameter correlating with clinical severity in Chiari type 1 malformation. Clin Neurol Neurosurg 174:123\u2013128. https:\/\/doi.org\/10.1016\/j.clineuro.2018.09.016","journal-title":"Clin Neurol Neurosurg"},{"issue":"3","key":"7388_CR7","doi-asserted-by":"publisher","first-page":"E7","DOI":"10.3171\/2022.12.FOCUS22630","volume":"54","author":"N Fatima","year":"2023","unstructured":"Fatima N, Swift DM, Montgomery EY et al (2023) Risk factors for clinical and radiological worsening following Chiari malformation type I surgery in the pediatric population. Neurosurg Focus 54:E7. https:\/\/doi.org\/10.3171\/2022.12.FOCUS22630","journal-title":"Neurosurg Focus"},{"key":"7388_CR8","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1055\/a-1932-8692","volume":"84","author":"Y He","year":"2023","unstructured":"He Y, Liu P, Zhang M et al (2023) A novel craniocervical junction compression severity index-based grading system for multidirectional quantification of the biomechanics at foramen magnum of Chiari malformation type I. J Neurol Surg B Skull Base 84:616\u2013628. https:\/\/doi.org\/10.1055\/a-1932-8692","journal-title":"J Neurol Surg B Skull Base"},{"key":"7388_CR9","doi-asserted-by":"publisher","first-page":"553","DOI":"10.3171\/jns.1999.91.4.0553","volume":"91","author":"JD Heiss","year":"1999","unstructured":"Heiss JD, Patronas N, DeVroom HL et al (1999) Elucidating the pathophysiology of syringomyelia. J Neurosurg 91:553\u2013562. https:\/\/doi.org\/10.3171\/jns.1999.91.4.0553","journal-title":"J Neurosurg"},{"key":"7388_CR10","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.nec.2022.08.007","volume":"34","author":"JD Heiss","year":"2023","unstructured":"Heiss JD (2023) Cerebrospinal fluid hydrodynamics in Chiari I malformation and syringomyelia: modeling pathophysiology. Neurosurg Clin N Am 34:81\u201390. https:\/\/doi.org\/10.1016\/j.nec.2022.08.007","journal-title":"Neurosurg Clin N Am"},{"key":"7388_CR11","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.3171\/2024.8.JNS241295","volume":"142","author":"DL Brockmeyer","year":"2025","unstructured":"Brockmeyer DL, Limbrick DD, Maher CO, Grant GA (2025) Primary rhombencephalopathy: introduction of a new paradigm for the evaluation and management of craniocervical hindbrain pathology. J Neurosurg 142:1205\u20131212. https:\/\/doi.org\/10.3171\/2024.8.JNS241295","journal-title":"J Neurosurg"},{"key":"7388_CR12","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.nec.2015.06.003","volume":"26","author":"TJ Buell","year":"2015","unstructured":"Buell TJ, Heiss JD, Oldfield EH (2015) Pathogenesis and cerebrospinal fluid hydrodynamics of the Chiari I malformation. Neurosurg Clin N Am 26:495\u2013499. https:\/\/doi.org\/10.1016\/j.nec.2015.06.003","journal-title":"Neurosurg Clin N Am"},{"key":"7388_CR13","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1227\/neu.0000000000002633","volume":"93","author":"DF Bauer","year":"2023","unstructured":"Bauer DF, Niazi T, Qaiser R et al (2023) Congress of neurological surgeons systematic review and evidence-based guidelines for patients with Chiari malformation: diagnosis. Neurosurgery 93:723\u2013726. https:\/\/doi.org\/10.1227\/neu.0000000000002633","journal-title":"Neurosurgery"},{"key":"7388_CR14","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2000.8.3.6","author":"RG Ellenbogen","year":"2000","unstructured":"Ellenbogen RG, Armonda RA, Shaw DWW, Winn HR (2000) Toward a rational treatment of Chiari I malformation and syringomyelia. Neurosurg Focus. https:\/\/doi.org\/10.3171\/foc.2000.8.3.6","journal-title":"Neurosurg Focus"},{"key":"7388_CR15","doi-asserted-by":"publisher","first-page":"E60","DOI":"10.1093\/neuros\/nyaa326","volume":"88","author":"J Lara-Reyna","year":"2021","unstructured":"Lara-Reyna J, Chae J, Tosi U et al (2021) Syringomyelia resolution following Chiari surgery: a novel scale for communication and research. Neurosurgery 88:E60\u2013E66. https:\/\/doi.org\/10.1093\/neuros\/nyaa326","journal-title":"Neurosurgery"},{"key":"7388_CR16","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1159\/000120969","volume":"23","author":"AH Menezes","year":"1995","unstructured":"Menezes AH (1995) Primary craniovertebral anomalies and the hindbrain herniation syndrome (Chiari I): data base analysis. Pediatr Neurosurg 23:260\u2013269. https:\/\/doi.org\/10.1159\/000120969","journal-title":"Pediatr Neurosurg"},{"key":"7388_CR17","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2000.8.3.3","author":"G Pinna","year":"2000","unstructured":"Pinna G, Alessandrini F, Alfieri A et al (2000) Cerebrospinal fluid flow dynamics study in Chiari I malformation: implications for syrinx formation. Neurosurg Focus. https:\/\/doi.org\/10.3171\/foc.2000.8.3.3","journal-title":"Neurosurg Focus"},{"key":"7388_CR18","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/s00381-002-0701-1","volume":"19","author":"ECG Ventureyra","year":"2003","unstructured":"Ventureyra ECG, Aziz HA, Vassilyadi M (2003) The role of cine flow MRI in children with Chiari I malformation. Childs Nerv Syst 19:109\u2013113. https:\/\/doi.org\/10.1007\/s00381-002-0701-1","journal-title":"Childs Nerv Syst"},{"key":"7388_CR19","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1227\/01.NEU.0000219841.73999.B3","volume":"59","author":"MJ McGirt","year":"2006","unstructured":"McGirt MJ, Nimjee SM, Fuchs HE, George TM (2006) Relationship of cine phase-contrast MRI to outcome after decompression for Chiari I malformation. Neurosurgery 59:140\u2013146. https:\/\/doi.org\/10.1227\/01.NEU.0000219841.73999.B3","journal-title":"Neurosurgery"},{"key":"7388_CR20","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","volume":"335","author":"E Elm","year":"2007","unstructured":"Elm E, Altman DG, Egger M et al (2007) Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 335:806\u2013808. https:\/\/doi.org\/10.1136\/bmj.39335.541782.AD","journal-title":"BMJ"},{"key":"7388_CR21","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.jclinepi.2010.03.002","volume":"64","author":"J Kottner","year":"2011","unstructured":"Kottner J, Audig\u00e9 L, Brorson S et al (2011) Guidelines for reporting reliability and agreement studies (GRRAS) were proposed. J Clin Epidemiol 64:96\u2013106. https:\/\/doi.org\/10.1016\/j.jclinepi.2010.03.002","journal-title":"J Clin Epidemiol"},{"key":"7388_CR22","doi-asserted-by":"publisher","first-page":"170","DOI":"10.3171\/2017.3.PEDS16604","volume":"20","author":"TC Hankinson","year":"2017","unstructured":"Hankinson TC, Tuite GF, Moscoso DI et al (2017) Analysis and interrater reliability of pB-C2 using MRI and CT: data from the Park-Reeves Syringomyelia Research Consortium on behalf of the Pediatric Craniocervical Society. J Neurosurg Pediatr 20:170\u2013175. https:\/\/doi.org\/10.3171\/2017.3.PEDS16604","journal-title":"J Neurosurg Pediatr"},{"key":"7388_CR23","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1007\/s10143-017-0830-3","volume":"41","author":"FC Henderson","year":"2018","unstructured":"Henderson FC, Henderson FC, Wilson WA et al (2018) Utility of the clivo-axial angle in assessing brainstem deformity: pilot study and literature review. Neurosurg Rev 41:149\u2013163. https:\/\/doi.org\/10.1007\/s10143-017-0830-3","journal-title":"Neurosurg Rev"},{"key":"7388_CR24","doi-asserted-by":"publisher","first-page":"439","DOI":"10.3171\/2020.4.PEDS20113","volume":"26","author":"VM Ravindra","year":"2020","unstructured":"Ravindra VM, Iyer RR, Awad A-W et al (2020) Defining the role of the condylar-C2 sagittal vertical alignment in Chiari malformation type I. J Neurosurg Pediatr 26:439\u2013444. https:\/\/doi.org\/10.3171\/2020.4.PEDS20113","journal-title":"J Neurosurg Pediatr"},{"key":"7388_CR25","doi-asserted-by":"publisher","first-page":"486","DOI":"10.3171\/2024.11.PEDS24478","volume":"35","author":"NG Alexiades","year":"2025","unstructured":"Alexiades NG, Anderson DI, D\u2019Ambrosio A et al (2025) Building consensus regarding the definition of abnormal craniocervical motion in pediatric patients with Chiari malformation: a modified Delphi study. J Neurosurg Pediatr 35:486\u2013496. https:\/\/doi.org\/10.3171\/2024.11.PEDS24478","journal-title":"J Neurosurg Pediatr"},{"key":"7388_CR26","doi-asserted-by":"publisher","first-page":"276","DOI":"10.11613\/BM.2012.031","volume":"22","author":"ML McHugh","year":"2012","unstructured":"McHugh ML (2012) Interrater reliability: the kappa statistic. Biochem Med 22:276\u2013282","journal-title":"Biochem Med"},{"key":"7388_CR27","doi-asserted-by":"publisher","first-page":"619","DOI":"10.3171\/2024.7.PEDS247","volume":"34","author":"T Johnstone","year":"2024","unstructured":"Johnstone T, Barros Guinle MI, Prolo LM, Grant GA (2024) Age as a predictor of reoperations and complications in surgically managed pediatric Chiari malformation type I. J Neurosurg Pediatr 34:619\u2013627. https:\/\/doi.org\/10.3171\/2024.7.PEDS247","journal-title":"J Neurosurg Pediatr"},{"key":"7388_CR28","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12082853","volume":"12","author":"G Talamonti","year":"2023","unstructured":"Talamonti G, Picano M, Fragale M et al (2023) Reoperation in Chiari-1 malformations. J Clin Med 12:2853. https:\/\/doi.org\/10.3390\/jcm12082853","journal-title":"J Clin Med"},{"key":"7388_CR29","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11123334","volume":"11","author":"S Knafo","year":"2022","unstructured":"Knafo S, Malcoci M, Morar S et al (2022) Surgical management after Chiari decompression failure: craniovertebral junction revision versus shunting strategies. J Clin Med 11:3334. https:\/\/doi.org\/10.3390\/jcm11123334","journal-title":"J Clin Med"},{"key":"7388_CR30","doi-asserted-by":"publisher","DOI":"10.1096\/fasebj.31.1_supplement.578.3","volume":"31","author":"AW Koons","year":"2017","unstructured":"Koons AW, Russell ML, Bliss KN et al (2017) Differences in foramen magnum size and shape among sexes in diverse populations. FASEB J 31:578.3. https:\/\/doi.org\/10.1096\/fasebj.31.1_supplement.578.3","journal-title":"FASEB J"},{"key":"7388_CR31","doi-asserted-by":"publisher","first-page":"465","DOI":"10.3171\/ped.2004.100.5.0465","volume":"100","author":"RS Tubbs","year":"2004","unstructured":"Tubbs RS, Smyth MD, Wellons JC, Oakes WJ (2004) Arachnoid veils and the Chiari I malformation. J Neurosurg Pediatr 100:465\u2013467. https:\/\/doi.org\/10.3171\/ped.2004.100.5.0465","journal-title":"J Neurosurg Pediatr"},{"key":"7388_CR32","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1002\/jmri.24013","volume":"38","author":"I Koerte","year":"2013","unstructured":"Koerte I, Haberl C, Schmidt M et al (2013) Inter\u2010 and intra\u2010rater reliability of blood and cerebrospinal fluid flow quantification by phase\u2010contrast MRI. J Magn Reson Imaging 38:655\u2013662. https:\/\/doi.org\/10.1002\/jmri.24013","journal-title":"J Magn Reson Imaging"},{"key":"7388_CR33","doi-asserted-by":"publisher","first-page":"176","DOI":"10.3171\/2020.12.PEDS20809","volume":"28","author":"VM Ravindra","year":"2021","unstructured":"Ravindra VM, Iyer RR, Yahanda AT et al (2021) A multicenter validation of the condylar\u2013C2 sagittal vertical alignment in Chiari malformation type I: a study using the Park-Reeves Syringomyelia Research Consortium. J Neurosurg Pediatr 28:176\u2013182. https:\/\/doi.org\/10.3171\/2020.12.PEDS20809","journal-title":"J Neurosurg Pediatr"},{"key":"7388_CR34","doi-asserted-by":"publisher","first-page":"66","DOI":"10.3171\/2024.1.PEDS23229","volume":"34","author":"AT Yahanda","year":"2024","unstructured":"Yahanda AT, Koueik J, Ackerman LL et al (2024) The role of occipital condyle and atlas anomalies on occipital cervical fusion outcomes in Chiari malformation type I with syringomyelia: a study from the Park-Reeves Syringomyelia Research Consortium. J Neurosurg Pediatr 34:66\u201374. https:\/\/doi.org\/10.3171\/2024.1.PEDS23229","journal-title":"J Neurosurg Pediatr"},{"key":"7388_CR35","doi-asserted-by":"publisher","first-page":"459","DOI":"10.3171\/2020.8.PEDS2087","volume":"27","author":"AT Yahanda","year":"2021","unstructured":"Yahanda AT, Adelson PD, Akbari SHA et al (2021) Dural augmentation approaches and complication rates after posterior fossa decompression for Chiari I malformation and syringomyelia: a Park-Reeves Syringomyelia Research Consortium study. J Neurosurg Pediatr 27:459\u2013468. https:\/\/doi.org\/10.3171\/2020.8.PEDS2087","journal-title":"J Neurosurg Pediatr"},{"key":"7388_CR36","doi-asserted-by":"publisher","first-page":"e490","DOI":"10.1016\/j.wneu.2018.04.077","volume":"115","author":"AD Bhimani","year":"2018","unstructured":"Bhimani AD, Esfahani DR, Denyer S et al (2018) Adult Chiari I malformations: an analysis of surgical risk factors and complications using an international database. World Neurosurg 115:e490\u2013e500. https:\/\/doi.org\/10.1016\/j.wneu.2018.04.077","journal-title":"World Neurosurg"}],"container-title":["Child's Nervous System"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-026-07388-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00381-026-07388-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-026-07388-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:31:37Z","timestamp":1783384297000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00381-026-07388-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["7388"],"URL":"https:\/\/doi.org\/10.1007\/s00381-026-07388-5","relation":{},"ISSN":["1433-0350"],"issn-type":[{"value":"1433-0350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"assertion":[{"value":"3 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"287"}}