{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:46:46Z","timestamp":1789670806292,"version":"4.0.1"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Occipital-cervical fusion (OCF) and ventral decompression (VD) may be used in the treatment of pediatric Chiari-1 malformation (CM-1) with syringomyelia (SM) as adjuncts to posterior fossa decompression (PFD) for complex craniovertebral junction pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To examine factors influencing the use of OCF and OCF\/VD in a multicenter cohort of pediatric CM-1 and SM subjects treated with PFD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The Park-Reeves Syringomyelia Research Consortium registry was used to examine 637 subjects with cerebellar tonsillar ectopia\u00a0\u2265\u00a05\u00a0mm, syrinx diameter\u00a0\u2265\u00a03\u00a0mm, and at least 1 yr of follow-up after their index PFD. Comparisons were made between subjects who received PFD alone and those with PFD\u00a0+\u00a0OCF or PFD\u00a0+\u00a0OCF\/VD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      All 637 patients underwent PFD, 505 (79.2%) with and 132 (20.8%) without duraplasty. A total of 12 subjects went on to have OCF at some point in their management (PFD\u00a0+\u00a0OCF), whereas 4 had OCF and VD (PFD\u00a0+\u00a0OCF\/VD). Of those with complete data, a history of platybasia (3\/10,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.011), Klippel-Feil (2\/10,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.015), and basilar invagination (3\/12,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001) were increased within the OCF group, whereas only basilar invagination (1\/4,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001) was increased in the OCF\/VD group. Clivo-axial angle (CXA) was significantly lower for both OCF (128.8\u00a0\u00b1 15.3\u00b0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.008) and OCF\/VD (115.0\u00a0\u00b1 11.6\u00b0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.025) groups when compared to PFD-only group (145.3\u00a0\u00b1 12.7\u00b0). pB-C2 did not differ among groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Although PFD alone is adequate for treating the vast majority of CM-1\/SM patients, OCF or OCF\/VD may be occasionally utilized. Cranial base and spine pathologies and CXA may provide insight into the need for OCF and\/or OCF\/VD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyaa460","type":"journal-article","created":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T19:34:16Z","timestamp":1600803256000},"page":"332-341","source":"Crossref","is-referenced-by-count":22,"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"],"prefix":"10.1227","volume":"88","author":[{"given":"Travis S","family":"CreveCoeur","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3630-1166","authenticated-orcid":false,"given":"Alexander T","family":"Yahanda","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cormac O","family":"Maher","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan School of Medicine, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle W","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie L","family":"Ackerman","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P David","family":"Adelson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raheel","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin at Madison, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory W","family":"Albert","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Arkansas Children's Hospital, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillipp R","family":"Aldana","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, University of Florida College of Medicine, Jacksonville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tord D","family":"Alden","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard C E","family":"Anderson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurological Surgery, Children's Hospital of New York, Columbia-Presbyterian, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lissa","family":"Baird","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David F","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin S","family":"Bierbrauer","sequence":"additional","affiliation":[{"name":"Division of 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Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C","family":"Dauser","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Texas Children's Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan R","family":"Durham","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Vermont, Burlington, Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G","family":"Ellenbogen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Seattle Children's Hospital, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin","family":"Eskandari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert E","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy M","family":"George","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Dell Children's Medical Center, Austin, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald A","family":"Grant","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Lucile Packard Children's Hospital at Stanford, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick C","family":"Graupman","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Gillette Children's Hospital, St. Paul, 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