Outcomes after suboccipital decompression without dural opening in XXXX with @entity1645 .

@entity6804 @entity1 @entity3976 @entity1645 @entity1109 @entity3627
UNASSIGNED: OBJECT Symptomatic pediatric @entity1645 ( @entity1645 ) is most often treated with @entity6804 ( @entity6804 ), but controversy exists over whether the dura needs to be opened during @entity6804 . While dural opening as a part of @entity6804 has been suggested to result in a higher rate of resolution of @entity1109 , it has also been shown to lead to more frequent complications. In this paper, the authors present the largest reported series of outcomes after @entity6804 without dural opening surgery, as well as identify risk factors for recurrence. METHODS The authors performed a retrospective review of 156 consecutive pediatric @entity1 in whom the senior authors performed @entity6804 without dural opening from 2003 to 2013. @entity1 demographics, clinical symptoms and signs, radiographic findings, intraoperative ultrasound results, and neuromonitoring findings were reviewed. Univariate and multivariate regression analyses were performed to determine risk factors for recurrence of symptoms and the need for reoperation. RESULTS Over 90% of @entity1 had a good clinical outcome, with improvement or resolution of their symptoms at last follow-up (mean 32 months). There were no major complications. The mean length of hospital stay was 2.0 days. In a multivariate regression model, partial @entity3627 laminectomy was an independent risk factor associated with reoperation (p = 0.037). Motor weakness on presentation was also associated with reoperation but only with trend-level significance (p = 0.075). No @entity1 with < 8 mm of @entity3976 required reoperation. CONCLUSIONS The vast majority (> 90%) of @entity1 with symptomatic @entity1645 will have improvement or resolution of symptoms after a @entity6804 without dural opening. A non-dural opening approach avoids major complications. While no @entity1 with @entity3976 < 8 mm required reoperation, @entity1 with @entity3976 at or below @entity3627 have a higher risk for failure when this approach is used.
