1.Magnetic Resonance Imaging-Related Anatomic and Functional Parameters for the Diagnosis and Prognosis of Chiari Malformation Type I: A Systematic Review and Meta-analysis
Zairan WANG ; Zhimin LI ; Shiyuan HAN ; Xianghui HU ; Siyuan PANG ; Yongning LI ; Jun GAO
Neurospine 2024;21(2):510-524
Objective:
Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging measurements in patients with CMI, analyze indicators that may assist in determining the severity of CMI, and guide its diagnosis and treatment.
Methods:
A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454).
Results:
Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard’s angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease.
Conclusion
We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients’ PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.
2.Magnetic Resonance Imaging-Related Anatomic and Functional Parameters for the Diagnosis and Prognosis of Chiari Malformation Type I: A Systematic Review and Meta-analysis
Zairan WANG ; Zhimin LI ; Shiyuan HAN ; Xianghui HU ; Siyuan PANG ; Yongning LI ; Jun GAO
Neurospine 2024;21(2):510-524
Objective:
Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging measurements in patients with CMI, analyze indicators that may assist in determining the severity of CMI, and guide its diagnosis and treatment.
Methods:
A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454).
Results:
Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard’s angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease.
Conclusion
We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients’ PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.
3.Magnetic Resonance Imaging-Related Anatomic and Functional Parameters for the Diagnosis and Prognosis of Chiari Malformation Type I: A Systematic Review and Meta-analysis
Zairan WANG ; Zhimin LI ; Shiyuan HAN ; Xianghui HU ; Siyuan PANG ; Yongning LI ; Jun GAO
Neurospine 2024;21(2):510-524
Objective:
Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging measurements in patients with CMI, analyze indicators that may assist in determining the severity of CMI, and guide its diagnosis and treatment.
Methods:
A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454).
Results:
Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard’s angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease.
Conclusion
We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients’ PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.
4.Magnetic Resonance Imaging-Related Anatomic and Functional Parameters for the Diagnosis and Prognosis of Chiari Malformation Type I: A Systematic Review and Meta-analysis
Zairan WANG ; Zhimin LI ; Shiyuan HAN ; Xianghui HU ; Siyuan PANG ; Yongning LI ; Jun GAO
Neurospine 2024;21(2):510-524
Objective:
Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging measurements in patients with CMI, analyze indicators that may assist in determining the severity of CMI, and guide its diagnosis and treatment.
Methods:
A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454).
Results:
Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard’s angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease.
Conclusion
We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients’ PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.
5.Magnetic Resonance Imaging-Related Anatomic and Functional Parameters for the Diagnosis and Prognosis of Chiari Malformation Type I: A Systematic Review and Meta-analysis
Zairan WANG ; Zhimin LI ; Shiyuan HAN ; Xianghui HU ; Siyuan PANG ; Yongning LI ; Jun GAO
Neurospine 2024;21(2):510-524
Objective:
Imaging parameters of Chiari malformation type I (CMI) development are not well established. This study aimed to collect evidence of general or specific imaging measurements in patients with CMI, analyze indicators that may assist in determining the severity of CMI, and guide its diagnosis and treatment.
Methods:
A comprehensive search was conducted across various databases including the Cochrane Library, PubMed, MEDLINE, Scopus, and Embase, covering the period from January 2002 to October 2023, following predefined inclusion criteria. Meta-analyses were performed using RevMan (ver. 5.4). We performed a quantitative summary and systematic analysis of the included studies. This study was registered in the PROSPERO (International Prospective Register of Systematic Reviews) prior to initiation (CRD42023415454).
Results:
Thirty-three studies met our inclusion criteria. The findings indicated that out of the 14 parameters examined, 6 (clivus length, basal angle, Boogard’s angle, supraocciput lengths, posterior cranial fossa [PCF] height, and volume) exhibited significant differences between the CMI group and the control group. Furthermore, apart from certain anatomical parameters that hold prognostic value for CMI, functional parameters like tonsillar movement, obex displacement, and cerebrospinal fluid dynamics serve as valuable indicators for guiding the clinical management of the disease.
Conclusion
We collated and established a set of linear, angular, and area measurements deemed essential for diagnosing CMI. However, more indicators can only be analyzed descriptively for various reasons, particularly in prognostic prediction. We posit that the systematic assessment of patients’ PCF morphology, volume, and other parameters at a 3-dimensional level holds promising clinical application prospects.
6.Efficacy of debridement combined with antibiotic-loaded artificial bone in treatment of clavicle osteomyelitis
Ruifang YANG ; Xinwei WANG ; Shilin WANG ; Xinxin LIU ; Zairan GUO ; Wenlong ZHONG ; Lei ZHANG ; Jiangfei CHEN
The Journal of Practical Medicine 2023;39(23):3065-3070
Objective To explore the efficacy of debridement combined with antibiotic-loaded artificial bone in the treatment of clavicular osteomyelitis.Methods The data of 45 patients with clavicle osteomyelitis admitted to Luoyang Orthopedic Hospital(Henan Orthopedic Hospital)in Henan Province from January 2012 to June 2022 were retrospectively analyzed.They were divided into treatment group(n = 24)treated with debridement combined with antibiotic-loaded artificial bone,and control group(n = 21)treated with debridement.We compared the operation time,the duration of drainage tube placement,wound healing time,white blood cells(WBC),C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR)in the two groups.Preoperative visual analog scores(VAS)and VAS 1 month after operation,and preoperative Constant-Murley score(CMS)and CMS 12 months after operation were observed.Infections,recurrence and complications in the two groups were recorded in the follow-up.Results All the 45 patients completed the surgery successfully and were followed up for 13 to 35 months,with an average of(23.53±5.11)months.The operation time and the duration of drainage tube place-ment of the treatment group were longer than those of the control group(P<0.05),and there was no significant difference in the wound healing time(P>0.05);preoperative and 14-day postoperative WBC,CRP,and ESR,VAS 1 month after operation,and CMS 12 months after operation were all significantly improved in the two groups.The differences were all statistically significant(P<0.05),and the CMS of the treatment group was higher than that of the control group(P<0.05).During the follow-up,there were less cases of infection recurrence in the treatment group when compared with that in the control group(2/24,8.33%vs.5/21,23.81%).There were 2 cases of aseptic exudation in the treatment group.There were 1 case of bone defect in the treatment group and 5 in the control group,all of which had healed after the second-stage iliac implantation,and the rest did not have the complication of aseptic exudation,bone defects and pathologic fracture.Conclusion Debridement and antibiotic-loaded artificial bone can effectively control the infection and preserve the shape and function of the clavicle,with a low recurrence rate of postoperative infection,simple surgical operation,and no serious complications.It is wor-thy of clinical promotion.