{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T04:19:24Z","timestamp":1782879564899,"version":"3.54.5"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"22","license":[{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,29]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The authors assessed the connection between clinical outcomes and morphometrics in patients with complex Chiari malformation (CM) who have undergone posterior fossa decompression (PFD) and subsequent occipitocervical fusion (OCF) with or without ventral decompression (VD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors retrospectively reviewed 33 patients with CM aged over 21 years who underwent PFD and OCF with or without endoscopic endonasal odontoidectomy at the authors\u2019 institution (21 OCF only and 12 OCF + VD). Clivoaxial angle (CXA), pB-C2 (perpendicular line to the line between the basion and C2), atlantodental interval (ADI), basion-dens interval (BDI), basion-axial interval (BAI), and C1 canal diameter were measured on preoperative and approximately 3-month postoperative computed tomography or magnetic resonance imaging scans. Common symptoms included headache, paresthesia, and bulbar symptoms. Clinical improvement after surgery was observed in 78.8% of patients. CXA, ADI, and BDI all significantly increased after surgery, whereas pB-C2 and BAI significantly decreased. OCF + VD had a significantly more acute CXA and longer pB-C2 preoperatively than OCF only. Patients who clinically improved postoperatively showed the same significant morphometric changes, but those who did not improve showed no significant morphometric changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Patients showing improvement had greater corrections in skull base morphometrics than those who did not. Although there are various mutually nonexclusive reasons why certain patients do not improve after surgery, smaller degrees of morphometric correction could play a role.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case21364","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T02:05:15Z","timestamp":1638151515000},"source":"Crossref","is-referenced-by-count":3,"title":["Predicting clinical outcomes using morphometric changes in adults with complex Chiari malformation undergoing occipitocervical fusion with or without ventral decompression: patient series"],"prefix":"10.3171","volume":"2","author":[{"given":"John K.","family":"Chae","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medicine\/NewYork-Presbyterian Hospital, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelan J.","family":"Marianayagam","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medicine\/NewYork-Presbyterian Hospital, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medicine\/NewYork-Presbyterian Hospital, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Cruz","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medicine\/NewYork-Presbyterian Hospital, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali A.","family":"Baaj","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Arizona College of Medicine, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"H\u00e4rtl","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medicine\/NewYork-Presbyterian Hospital, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P.","family":"Greenfield","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medicine\/NewYork-Presbyterian Hospital, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1097\/00006123-199905000-00042","article-title":"Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients","volume":"44","author":"Milhorat TH","year":"1999","unstructured":"Milhorat TH, Chou MW, Trinidad EM,  Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. 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