TY - JOUR
T1 - Diagnosis and treatment of Chiari malformation type 1 in children
T2 - the International Consensus Document
AU - Massimi, Luca
AU - Peretta, Paola
AU - Erbetta, Alessandra
AU - Solari, Alessandra
AU - Farinotti, Mariangela
AU - Ciaramitaro, Palma
AU - Saletti, Veronica
AU - Caldarelli, Massimo
AU - Canheu, Alexandre Casagrande
AU - Celada, Carlo
AU - Chiapparini, Luisa
AU - Chieffo, Daniela
AU - Cinalli, Giuseppe
AU - Di Rocco, Federico
AU - Furlanetto, Marika
AU - Giordano, Flavio
AU - Jallo, George
AU - James, Syril
AU - Lanteri, Paola
AU - Lemarchand, Christian
AU - Messing-Jünger, Martina
AU - Parazzini, Cecilia
AU - Paternoster, Giovanna
AU - Piatelli, Gianluca
AU - Poca, Maria A.
AU - Prabahkar, Prab
AU - Ricci, Federica
AU - Righini, Andrea
AU - Sala, Francesco
AU - Sahuquillo, Juan
AU - Stoodley, Marcus
AU - Talamonti, Giuseppe
AU - Thompson, Dominic
AU - Triulzi, Fabio
AU - Zucchelli, Mino
AU - Valentini, Laura
AU - International Experts - Jury of the Chiari & Syringomyelia Consensus Conference, “Milan, November 11–13, 2019”
N1 - Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2022/2
Y1 - 2022/2
N2 - Background: 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. Methods: 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). Results: 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.” Conclusions: 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.
AB - Background: 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. Methods: 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). Results: 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.” Conclusions: 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.
KW - Chiari 1 malformation
KW - Children
KW - Consensus
KW - Craniovertebral decompression
KW - Management
KW - Syringomyelia
UR - http://www.scopus.com/inward/record.url?scp=85107742133&partnerID=8YFLogxK
U2 - 10.1007/s10072-021-05317-9
DO - 10.1007/s10072-021-05317-9
M3 - Article
C2 - 34097175
AN - SCOPUS:85107742133
SN - 1590-1874
VL - 43
SP - 1311
EP - 1326
JO - Neurological Sciences
JF - Neurological Sciences
IS - 2
ER -