Three Different Surgical Treatments For Chiari Malformation Type ?:a Meta-analysis

Objective To compared the clinical efficacy of PFD?PFDD and TR for the treatment of CM-I.Methods Pub Med,EBSCO,Em Base,Medline(OVID),CNKI,VIP and Wangfang database were retrieved.The retrieval time was from the establishment of the database to July 1,2017.The relevant literature was obtained according to the inclusion and exclusion criteria,the data were extracted and a Meta-analysis was performed by Revman 5.2 software.The quality of the literature was evaluated by using the NOS scale.Results Finally a total of 26 trials with 4553 patients were enrolled,including 2101 males and 2452 females.PFD and PFDD group meta analys is results: compared with PFD group,the postoperative clinical symptoms ra te was higher(RR=0.82,95%CI(0.70,0.97),P=0.02),reoperation rate was lower(OR=1.96,95%CI(1.05,3.67),P=0.04),postoperative infection was higher(OR=0.54,95%CI(0.31,0.92),P=0.02),cerebrospinal fluid leakage rate was higher(O R=0.20,95%CI(0.10,0.43),P<0.0001),pseudomeningocele rate was higher(OR=0.69,95%CI(0.48,0.98),P=0.04),aseptic meningitis was higher(OR=0.23,95%CI(0.08,0.69),P=0.008)of the PFD.There was no significant differences in the syringomyelia recovery(P=0.13),subcutaneous effusion(P=0.31),postoper ative pain(P=0.77).PFDD group and TR group meta analysis results: There was no significant differences in the short-term improvement of postoperative clinical symptoms(P=0.33),postoperative cerebrospinal fluid leakage(P=0.40),postoperative headache(P=0.23),postoperative infection(P=0.80).Conclusion Compared with PFD,PFDD and TR are more conducive to the improvement of postoperative symptoms.But postoperative infection rate,cerebrospinal fluid leakage rate,pseudotumor bulge rate and aseptic meningitis rate were higher.