Diagnosis and treatment of Chiari malformation type 1 in children

Chiari malformation type 1 (CM1) is a rare condition where agreed classification and treatment are still missing. The goal of this study is to achieve a consensus on the diagnosis and treatment of CM1 in children. A multidisciplinary panel formulated 57 provisional statements based on a review of th...

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Detalles Bibliográficos
Autores: Massimi, Luca|||0000-0003-3088-0822, Peretta, Paola, Erbetta, Alessandra, Solari, Alessandra|||0000-0001-9930-7579, Farinotti, Mariangela, Ciaramitaro, Palma, Saletti, Veronica, Caldarelli, Massimo, Canheu, Alexandre Casagrande, Celada, Carlo, Chiapparini, Luisa, Chieffo, Daniela, Cinalli, Giuseppe, Di Rocco, Federico, Furlanetto, Marika, Giordano, Flavio, Jallo, George, James, Syril, Lanteri, Paola, Lemarchand, Christian, Messing-Jünger, Martina, Parazzini, Cecilia, Paternoster, Giovanna, Piatelli, Gianluca, Poca Pastor, María Antonia|||0000-0002-3831-0536, Prabahkar, Prab, Ricci, Federica, Righini, Andrea, Sala, Francesco, Sahuquillo Barris, Juan|||0000-0003-0713-5875, Stoodley, Marcus, Talamonti, Giuseppe, Thompson, Dominic, Triulzi, Fabio, Zucchelli, Mino, Valentini, Laura
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:255695
Acceso en línea:https://ddd.uab.cat/record/255695
https://dx.doi.org/urn:doi:10.1007/s10072-021-05317-9
Access Level:acceso abierto
Palabra clave:Chiari 1 malformation
Syringomyelia
Consensus
Children
Craniovertebral decompression
Management
Descripción
Sumario:Chiari malformation type 1 (CM1) is a rare condition where agreed classification and treatment are still missing. The goal of this study is to achieve a consensus on the diagnosis and treatment of CM1 in children. A multidisciplinary panel formulated 57 provisional statements based on a review of the literature. Thirty-four international experts (IE) participated in a Delphi study by independently rating each statement on a 4-point Likert scale ("strongly disagree," "disagree," "agree," "strongly agree"). Statements that were endorsed ("agree" or "strongly agree") by < 75% of raters were re-formulated, or new statements were added, and another Delphi round followed (up to a maximum of three). Thirty-five IE were contacted and 34 agreed to participate. A consensus was reached on 30/57 statements (52.6%) after round 1. Three statements were added, and one removed. After round 2, agreement was reached on 56/59 statements (94.9%). Finally, after round 3, which took place during the 2019 Chiari Consensus Conference (Milan, Italy), agreement was reached on 58/59 statements (98.3%) about four main sections (Definition and Classification, Planning, Surgery, Isolated Syringomyelia). Only one statement did not gain a consensus, which is the "definition of radiological failure 24 month post-surgery." The consensus document consists of 58 statements (24 on diagnosis, 34 on treatment), serving clinicians and researchers following children with CM1. There is a clear need for establishing an international network and registry and to promote collaborative studies to increase the evidence base and optimize the long-term care of this patient population.

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