{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T07:58:12Z","timestamp":1780387092481,"version":"3.54.1"},"reference-count":96,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T00:00:00Z","timestamp":1719705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Regional Development Fund (ERDF)","award":["FIS PI22\/01082"],"award-info":[{"award-number":["FIS PI22\/01082"]}]},{"name":"European Regional Development Fund (ERDF)","award":["2021SGR\/00810"],"award-info":[{"award-number":["2021SGR\/00810"]}]},{"name":"Ag\u00e8ncia de Gesti\u00f3 d\u2019Ajuts Universitaris i de Recerca (AGAUR)","award":["FIS PI22\/01082"],"award-info":[{"award-number":["FIS PI22\/01082"]}]},{"name":"Ag\u00e8ncia de Gesti\u00f3 d\u2019Ajuts Universitaris i de Recerca (AGAUR)","award":["2021SGR\/00810"],"award-info":[{"award-number":["2021SGR\/00810"]}]},{"name":"nongovernmental associations","award":["FIS PI22\/01082"],"award-info":[{"award-number":["FIS PI22\/01082"]}]},{"name":"nongovernmental associations","award":["2021SGR\/00810"],"award-info":[{"award-number":["2021SGR\/00810"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The management of Chiari malformations (CMs) remains a clinical challenge and a topic of great controversy. Results may vary between children and adults. The purpose of the current single-center study is to critically assess the one-year surgical outcomes of a cohort of 110 children with CM-1 or CM-1.5 who were treated using \u201cposterior fossa reconstruction\u201d (PFR), a surgical technique described in 1994 that has since been used in both adults and children. We also review the literature and discuss the possible causes of the drawbacks and pitfalls in children in whom PFR was ineffective in controlling the disease. Methods: The present cohort was selected from a prospective registry of adults and children with CMs collected since 2006. Patients included in this study were selected from a group of children with CMs who were operated on in our Pediatric Neurosurgical Unit between 1 January 2007 and 31 November 2023. Surgical outcome was defined based on clinical and neuroradiological results as very good, good, or bad. Results: The mean age of our child cohort was 9.9 \u00b1 4.7 years, with 54 girls (49%) and 56 boys (51%). Sixty-six children had CM-1 (60%) while forty-four had CM-1.5 (40%). Following surgery, there was no neurological worsening or death among the children. Most children (70%) had an uneventful recovery and were discharged home on average one week after surgery. However, in 33 children (30%), we recorded at least one postoperative adverse event. Aseptic meningitis syndrome was the most frequent adverse event (n = 25, 22.7%). The final surgical outcome was evaluated one year after PFR by using both clinical and neuroradiological results. The one-year surgical outcome was excellent in 101 children (91.9%), good in 5 (4.5%), and bad in 4 (3.6%). Conclusions: PFR significantly enlarges the volume of the posterior fossa and recreates a CSF environment that generates buoyancy of the cerebellum, with a high percentage of excellent and good clinical results evaluated one year post-surgery.<\/jats:p>","DOI":"10.3390\/jcm13133852","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T09:06:07Z","timestamp":1719824767000},"page":"3852","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Surgical Outcomes in Chiari 1 and Chiari 1.5 Malformation Treated by Posterior Fossa Reconstruction: A Comprehensive Analysis of 110 Pediatric Cases and Literature Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3831-0536","authenticated-orcid":false,"given":"Maria A.","family":"Poca","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Vall d\u2019Hebron University Hospital, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Neurotraumatology and Neurosurgery Research Unit, Vall d\u2019Hebron Institut de Recerca (VHIR), Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Department of Surgery (Neurosurgery), Universitat Aut\u00f2noma de Barcelona, 08193 Bellaterra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Lopez-Bermeo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Vall d\u2019Hebron University Hospital, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Neurotraumatology and Neurosurgery Research Unit, Vall d\u2019Hebron Institut de Recerca (VHIR), Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2877-8239","authenticated-orcid":false,"given":"Dulce","family":"Moncho","sequence":"additional","affiliation":[{"name":"Neurotraumatology and Neurosurgery Research Unit, Vall d\u2019Hebron Institut de Recerca (VHIR), Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Clinical Neurophysiology Department, Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Ferre","sequence":"additional","affiliation":[{"name":"Neurotraumatology and Neurosurgery Research Unit, Vall d\u2019Hebron Institut de Recerca (VHIR), Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Clinical Neurophysiology Department, Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Sleep Unit, Pneumology Department, Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Sanchez-Monta\u00f1ez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neuroradiology, Institut de Diagnostic per la Imatge (IDI), Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Mestres","sequence":"additional","affiliation":[{"name":"Neurotraumatology and Neurosurgery Research Unit, Vall d\u2019Hebron Institut de Recerca (VHIR), Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Department of Surgery (Neurosurgery), Universitat Aut\u00f2noma de Barcelona, 08193 Bellaterra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5192-396X","authenticated-orcid":false,"given":"Sandra","family":"Galve","sequence":"additional","affiliation":[{"name":"Pediatric Anesthesiology Department, Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0713-5875","authenticated-orcid":false,"given":"Juan","family":"Sahuquillo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Vall d\u2019Hebron University Hospital, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Neurotraumatology and Neurosurgery Research Unit, Vall d\u2019Hebron Institut de Recerca (VHIR), Vall d\u2019Hebron Hospital Universitari, Vall d\u2019Hebron Barcelona Hospital Campus, Passeig Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Department of Surgery (Neurosurgery), Universitat Aut\u00f2noma de Barcelona, 08193 Bellaterra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,30]]},"reference":[{"key":"ref_1","first-page":"1172","article-title":"\u00dcber Ver\u00e4nderungen des Kleinhirns Infolge von Hydrocephalie des Grosshirns","volume":"Volume 17","author":"Chiari","year":"1861","journal-title":"Denkschriften der Kaiserlichen Akademie der Wissenschaften\/Mathematisch-Naturwissenschaftliche Classe"},{"key":"ref_2","unstructured":"Chiari, H. 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