{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T07:57:56Z","timestamp":1780387076001,"version":"3.54.1"},"reference-count":30,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"am","delay-in-days":306,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015015","name":"Government of South Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015015","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","theclinics.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Neurosurgery Clinics of North America"],"published-print":{"date-parts":[[2023,1]]},"DOI":"10.1016\/j.nec.2022.08.009","type":"journal-article","created":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T02:50:24Z","timestamp":1667443824000},"page":"143-150","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":8,"title":["Complex Chiari Malformations"],"prefix":"10.1016","volume":"34","author":[{"given":"Vijay M.","family":"Ravindra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas L.","family":"Brockmeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"6","key":"10.1016\/j.nec.2022.08.009_bib1","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1136\/jnnp.31.6.596","article-title":"Basilar impression and Arnold-Chiari malformation. A study of 66 cases","volume":"31","author":"Caetano de Barros","year":"1968","journal-title":"J\u00a0Neurol Neurosurg Psychiatry"},{"issue":"1","key":"10.1016\/j.nec.2022.08.009_bib2","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3171\/2017.8.PEDS17345","article-title":"Morphometric and volumetric comparison of 102 children with symptomatic and asymptomatic Chiari malformation Type I","volume":"21","author":"Khalsa","year":"2018","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"10","key":"10.1016\/j.nec.2022.08.009_bib3","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1007\/s00381-019-04214-z","article-title":"Complex Chiari malformation: using craniovertebral junction metrics to guide treatment","volume":"35","author":"Ho","year":"2019","journal-title":"Childs Nerv Syst"},{"issue":"1","key":"10.1016\/j.nec.2022.08.009_bib4","doi-asserted-by":"crossref","first-page":"39","DOI":"10.3171\/2022.2.PEDS21446","article-title":"Complications and outcomes of posterior fossa decompression with duraplasty versus without duraplasty for pediatric patients with Chiari malformation type I and syringomyelia: a study from the Park-Reeves Syringomyelia Research Consortium","volume":"30","author":"Akbari","year":"2022","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"8","key":"10.1016\/j.nec.2022.08.009_bib5","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1007\/s00381-014-2424-5","article-title":"Comparison of posterior fossa decompression with or without duraplasty in children with Type I Chiari malformation","volume":"30","author":"Lee","year":"2014","journal-title":"Childs Nerv Syst"},{"issue":"2","key":"10.1016\/j.nec.2022.08.009_bib6","doi-asserted-by":"crossref","first-page":"134","DOI":"10.3171\/2012.3.PEDS11340","article-title":"Complex Chiari malformations in children: an analysis of preoperative risk factors for occipitocervical fusion","volume":"10","author":"Bollo","year":"2012","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"3","key":"10.1016\/j.nec.2022.08.009_bib7","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1097\/00006123-199903000-00050","article-title":"Ventral brain stem compression in pediatric and young adult patients with Chiari I malformations","volume":"44","author":"Grabb","year":"1999","journal-title":"Neurosurgery"},{"issue":"2 Suppl","key":"10.1016\/j.nec.2022.08.009_bib8","doi-asserted-by":"crossref","first-page":"179","DOI":"10.3171\/ped.2004.101.2.0179","article-title":"A\u00a0critical analysis of the Chiari 1.5 malformation","volume":"101","author":"Tubbs","year":"2004","journal-title":"J\u00a0Neurosurg"},{"issue":"4","key":"10.1016\/j.nec.2022.08.009_bib9","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/BF01743100","article-title":"Craniocervical abnormalities. Modern diagnosis and a comprehensive surgical approach","volume":"6","author":"Nagashima","year":"1983","journal-title":"Neurosurg Rev"},{"issue":"2","key":"10.1016\/j.nec.2022.08.009_bib10","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1148\/radiographics.14.2.8190952","article-title":"Craniovertebral junction: normal anatomy, craniometry, and congenital anomalies","volume":"14","author":"Smoker","year":"1994","journal-title":"Radiographics"},{"issue":"2","key":"10.1016\/j.nec.2022.08.009_bib11","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1093\/neuros\/nyaa460","article-title":"Occipital-cervical fusion and ventral decompression in the surgical management of Chiari-1 malformation and syringomyelia: analysis of data from the Park-Reeves Syringomyelia Research Consortium","volume":"88","author":"CreveCoeur","year":"2021","journal-title":"Neurosurgery"},{"issue":"4","key":"10.1016\/j.nec.2022.08.009_bib12","doi-asserted-by":"crossref","first-page":"439","DOI":"10.3171\/2020.4.PEDS20113","article-title":"Defining the role of the condylar-C2 sagittal vertical alignment in Chiari malformation type I","volume":"26","author":"Ravindra","year":"2020","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"2","key":"10.1016\/j.nec.2022.08.009_bib13","doi-asserted-by":"crossref","first-page":"176","DOI":"10.3171\/2020.12.PEDS20809","article-title":"A multicenter validation of the condylar-C2 sagittal vertical alignment in Chiari malformation type I: a study using the Park-Reeves Syringomyelia Research Consortium","volume":"28","author":"Ravindra","year":"2021","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"6","key":"10.1016\/j.nec.2022.08.009_bib14","doi-asserted-by":"crossref","first-page":"554","DOI":"10.3171\/2010.3.PEDS09489","article-title":"Chiari malformation Type I in children younger than age 6 years: presentation and surgical outcome","volume":"5","author":"Albert","year":"2010","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"4","key":"10.1016\/j.nec.2022.08.009_bib15","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.nec.2015.06.002","article-title":"Complex Chiari malformations in children: diagnosis and management","volume":"26","author":"Brockmeyer","year":"2015","journal-title":"Neurosurg Clin N Am"},{"issue":"3","key":"10.1016\/j.nec.2022.08.009_bib16","doi-asserted-by":"crossref","first-page":"248","DOI":"10.3171\/2010.12.PEDS10379","article-title":"Institutional experience with 500 cases of surgically treated pediatric Chiari malformation Type I","volume":"7","author":"Tubbs","year":"2011","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"3","key":"10.1016\/j.nec.2022.08.009_bib17","doi-asserted-by":"crossref","first-page":"216","DOI":"10.3171\/spi.2007.6.3.216","article-title":"Surgical outcomes in adult patients with syringomyelia associated with Chiari malformation type I: the relationship between scoliosis and neurological findings","volume":"6","author":"Ono","year":"2007","journal-title":"J\u00a0Neurosurg Spine"},{"issue":"1","key":"10.1016\/j.nec.2022.08.009_bib18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/SPI\/2008\/9\/7\/001","article-title":"Craniocervical junction fusions in patients with hindbrain herniation and syringohydromyelia","volume":"9","author":"Fenoy","year":"2008","journal-title":"J\u00a0Neurosurg Spine"},{"issue":"2","key":"10.1016\/j.nec.2022.08.009_bib19","doi-asserted-by":"crossref","first-page":"221","DOI":"10.3171\/2020.12.PEDS20729","article-title":"Endoscopic transnasal\/transoral odontoid resection in children: results of a combined neurosurgical and otolaryngological protocolized, institutional approach","volume":"28","author":"Iyer","year":"2021","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"6","key":"10.1016\/j.nec.2022.08.009_bib20","doi-asserted-by":"crossref","first-page":"549","DOI":"10.3171\/2010.2.PEDS09362","article-title":"Transnasal odontoid resection followed by posterior decompression and occipitocervical fusion in children with Chiari malformation Type I and ventral brainstem compression","volume":"5","author":"Hankinson","year":"2010","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"Suppl 3","key":"10.1016\/j.nec.2022.08.009_bib21","doi-asserted-by":"crossref","first-page":"S345","DOI":"10.1007\/s10072-011-0690-5","article-title":"The complex Chiari: issues and management strategies","volume":"32","author":"Brockmeyer","year":"2011","journal-title":"Neurol Sci"},{"issue":"4","key":"10.1016\/j.nec.2022.08.009_bib22","doi-asserted-by":"crossref","first-page":"459","DOI":"10.3171\/2020.8.PEDS2087","article-title":"Dural augmentation approaches and complication rates after posterior fossa decompression for Chiari I malformation and syringomyelia: a Park-Reeves Syringomyelia Research Consortium study","volume":"27","author":"Yahanda","year":"2021","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"5","key":"10.1016\/j.nec.2022.08.009_bib23","first-page":"1356","article-title":"Outcomes for various dural graft materials after posterior fossa decompression with duraplasty for Chiari malformation type I: a systematic review and meta-analysis","volume":"135","author":"Yahanda","year":"2021","journal-title":"J\u00a0Neurosurg"},{"issue":"4","key":"10.1016\/j.nec.2022.08.009_bib24","doi-asserted-by":"crossref","first-page":"380","DOI":"10.3171\/2009.10.PEDS09296","article-title":"Equivalence of fusion rates after rigid internal fixation of the occiput to C-2 with or without C-1 instrumentation","volume":"5","author":"Hankinson","year":"2010","journal-title":"J\u00a0Neurosurg Pediatr"},{"key":"10.1016\/j.nec.2022.08.009_bib25","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.wneu.2017.07.172","article-title":"A\u00a0modified technique for occipitocervical fusion using compressed iliac crest allograft results in a high rate of fusion in the pediatric population","volume":"107","author":"Iyer","year":"2017","journal-title":"World Neurosurg"},{"issue":"5","key":"10.1016\/j.nec.2022.08.009_bib26","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1093\/ons\/opy013","article-title":"Comparison of fusion rates based on graft material following occipitocervical and atlantoaxial arthrodesis in adults and children","volume":"15","author":"Robinson","year":"2018","journal-title":"Oper Neurosurg (Hagerstown)"},{"issue":"5","key":"10.1016\/j.nec.2022.08.009_bib27","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1227\/NEU.0b013e3181f258ba","article-title":"Routine use of recombinant human bone morphogenetic protein-2 in posterior fusions of the pediatric spine: safety profile and efficacy in the early postoperative period","volume":"67","author":"Fahim","year":"2010","journal-title":"Neurosurgery"},{"issue":"5","key":"10.1016\/j.nec.2022.08.009_bib28","doi-asserted-by":"crossref","first-page":"468","DOI":"10.3171\/2011.2.PEDS10487","article-title":"Complications associated with recombinant human bone morphogenetic protein use in pediatric craniocervical arthrodesis","volume":"7","author":"Lindley","year":"2011","journal-title":"J\u00a0Neurosurg Pediatr"},{"issue":"12","key":"10.1016\/j.nec.2022.08.009_bib29","doi-asserted-by":"crossref","first-page":"877","DOI":"10.7326\/0003-4819-158-12-201306180-00005","article-title":"Safety and effectiveness of recombinant human bone morphogenetic protein-2 for spinal fusion: a meta-analysis of individual-participant data","volume":"158","author":"Simmonds","year":"2013","journal-title":"Ann Intern Med"},{"issue":"5","key":"10.1016\/j.nec.2022.08.009_bib30","doi-asserted-by":"crossref","first-page":"465","DOI":"10.3171\/2014.7.PEDS1432","article-title":"Avoiding early complications and reoperation during occipitocervical fusion in pediatric patients","volume":"14","author":"Mazur","year":"2014","journal-title":"J\u00a0Neurosurg Pediatr"}],"container-title":["Neurosurgery Clinics of North America"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1042368022000791?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1042368022000791?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T20:04:00Z","timestamp":1760904240000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1042368022000791"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["S1042368022000791"],"URL":"https:\/\/doi.org\/10.1016\/j.nec.2022.08.009","relation":{},"ISSN":["1042-3680"],"issn-type":[{"value":"1042-3680","type":"print"}],"subject":[],"published":{"date-parts":[[2023,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Complex Chiari Malformations","name":"articletitle","label":"Article Title"},{"value":"Neurosurgery Clinics of North America","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.nec.2022.08.009","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}