{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:25:50Z","timestamp":1794018350492,"version":"4.8.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Posterior fossa decompression with duraplasty (PFDD) is commonly performed for Chiari I malformation (CM-I) with syringomyelia (SM). However, complication rates associated with various dural graft types are not well established. The objective of this study was to elucidate complication rates within 6 months of surgery among autograft and commonly used nonautologous grafts for pediatric patients who underwent PFDD for CM-I\/SM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The Park-Reeves Syringomyelia Research Consortium database was queried for pediatric patients who had undergone PFDD for CM-I with SM. All patients had tonsillar ectopia \u2265 5 mm, syrinx diameter \u2265 3 mm, and \u2265 6 months of postoperative follow-up after PFDD. Complications (e.g., pseudomeningocele, CSF leak, meningitis, and hydrocephalus) and postoperative changes in syrinx size, headaches, and neck pain were compared for autograft versus nonautologous graft.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 781 PFDD cases were analyzed (359 autograft, 422 nonautologous graft). Nonautologous grafts included bovine pericardium (n = 63), bovine collagen (n = 225), synthetic (n = 99), and human cadaveric allograft (n = 35). Autograft (103\/359, 28.7%) had a similar overall complication rate compared to nonautologous graft (143\/422, 33.9%) (p = 0.12). However, nonautologous graft was associated with significantly higher rates of pseudomeningocele (p = 0.04) and meningitis (p &lt; 0.001). The higher rate of meningitis was influenced particularly by the higher rate of chemical meningitis (p = 0.002) versus infectious meningitis (p = 0.132). Among 4 types of nonautologous grafts, there were differences in complication rates (p = 0.02), including chemical meningitis (p = 0.01) and postoperative nausea\/vomiting (p = 0.03). Allograft demonstrated the lowest complication rates overall (14.3%) and yielded significantly fewer complications compared to bovine collagen (p = 0.02) and synthetic (p = 0.003) grafts. Synthetic graft yielded higher complication rates than autograft (p = 0.01). Autograft and nonautologous graft resulted in equal improvements in syrinx size (p &lt; 0.0001). No differences were found for postoperative changes in headaches or neck pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In the largest multicenter cohort to date, complication rates for dural autograft and nonautologous graft are similar after PFDD for CM-I\/SM, although nonautologous graft results in higher rates of pseudomeningocele and meningitis. Rates of meningitis differ among nonautologous graft types. Autograft and nonautologous graft are equivalent for reducing syrinx size, headaches, and neck pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2020.8.peds2087","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T02:11:55Z","timestamp":1613095915000},"page":"459-468","source":"Crossref","is-referenced-by-count":27,"title":["Dural augmentation approaches and complication rates after posterior fossa decompression for Chiari I malformation and syringomyelia: a Park-Reeves Syringomyelia Research Consortium study"],"prefix":"10.3171","volume":"27","author":[{"given":"Alexander T.","family":"Yahanda","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. David","family":"Adelson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Barrow Neurological Institute at Phoenix Children\u2019s Hospital, Phoenix, AZ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Hassan A.","family":"Akbari","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, University of Alabama at Birmingham, AL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory W.","family":"Albert","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Arkansas Children\u2019s Hospital, Little Rock, AR;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp R.","family":"Aldana","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, University of Florida College of Medicine, Jacksonville, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tord D.","family":"Alden","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children\u2019s Hospital of Chicago, IL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard C. E.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurological Surgery, Children\u2019s Hospital of New York, Columbia-Presbyterian, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David F.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy","family":"Bethel-Anderson","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas L.","family":"Brockmeyer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Primary Children\u2019s Hospital, Salt Lake City, UT;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua J.","family":"Chern","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Children\u2019s Healthcare of Atlanta, GA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E.","family":"Couture","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Daniels","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, MN;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"Dlouhy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan R.","family":"Durham","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Vermont, Burlington, VT;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G.","family":"Ellenbogen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Seattle Children\u2019s Hospital, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin","family":"Eskandari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of South Carolina, Charleston, SC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy M.","family":"George","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Dell Children\u2019s Medical Center, Austin, TX;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald A.","family":"Grant","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Lucile Packard Children\u2019s Hospital, Palo Alto, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick C.","family":"Graupman","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Gillette Children\u2019s Hospital, St. Paul, MN;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Greene","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Children\u2019s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P.","family":"Greenfield","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naina L.","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Oklahoma, Oklahoma City, OK;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Guillaume","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, MN;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd C.","family":"Hankinson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s Hospital Colorado, Aurora, CO;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory G.","family":"Heuer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Children\u2019s Hospital of Pennsylvania, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Iantosca","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Penn State Milton S. Hershey Medical Center, Hershey, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bermans J.","family":"Iskandar","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin at Madison, WI;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric M.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, University of Alabama at Birmingham, AL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Keating","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s National Medical Center, Washington, DC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Krieger","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Children\u2019s Hospital of Los Angeles, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Leonard","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Nationwide Children\u2019s Hospital, Columbus, OH;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cormac O.","family":"Maher","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, MI;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco T.","family":"Mangano","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Cincinnati Children\u2019s Medical Center, Cincinnati, OH;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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