TY - JOUR AU - Passias, Peter G. AU - Pyne, Alexandra AU - Horn, Samantha R. AU - Poorman, Gregory W. AU - Janjua, Muhammad B. AU - Vasquez-Montes, Dennis AU - Bortz, Cole A. AU - Segreto, Frank A. AU - Frangella, Nicholas J. AU - Siow, Matthew Y. AU - Sure, Akhila AU - Zhou, Peter L. AU - Moon, John Y. AU - Diebo, Bassel G. AU - Vira, Shaleen N. PY - 2018 TI - Developments in the treatment of Chiari type 1 malformations over the past decade JF - Journal of Spine Surgery; Vol 4, No 1 (March 04, 2018): Journal of Spine Surgery Y2 - 2018 KW - N2 - Background: Chiari malformations type 1 (CM-1), a developmental anomaly of the posterior fossa, usually presents in adolescence or early adulthood. There are few studies on the national incidence of CM-1, taking into account outcomes based on concurrent diagnoses. To quantify trends in CM-1 treatment and associated diagnoses. Retrospective review of the Kids’ Inpatient Database (KID) from 2003–2012. Methods: Patients, aged 0–20, with primary diagnosis of CM-1 in the KID database were identified. Demographics and concurrent diagnoses were analyzed using chi-squared and t-tests for categorical and numerical variables, respectively. Trends in diagnosis, treatments, and outcomes were analyzed using analysis of variance (ANOVA). Results: Five thousand four hundred and thirty-eight patients were identified in the KID database with primary diagnosis of CM-1 (10.5 years, 55% female). CM-1 primary diagnoses have increased over time (45 to 96 per 100,000). CM-1 patients had the following concurrent diagnoses: 23.8% syringomyelia/syringobulbia, 11.5% scoliosis, 5.9% hydrocephalus, 2.2% tethered cord syndrome. Eighty-three point four percent of CM-1 patients underwent surgical treatment, and rate of surgical treatment for CM-1 increased from 2003–2012 (66% to 72%, P vs . 4.7%). Seven point four percent of patients experienced at least one peri-operative complication (nervous system, dysphagia, respiratory most common). Patients with concurrent hydrocephalus had increased nervous and respiratory systems, urinary, and respiratory complications (P Conclusions: CM-1 malformation diagnoses have increased in the last decade. Despite the decrease in overall complication rates, fusions are becoming more common and are associated with higher peri-operative complication rates. Commonly associated diagnoses including syringomyelia and hydrocephalus, can dramatically increase experienced complication rates. UR - https://jss.amegroups.org/article/view/4087