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Increase in clivo-axial angle is associated with clinical improvement in children undergoing occipitocervical fusion for complex Chiari malformation: patient series

Neelan J. Marianayagam, John K. Chae, Ibrahim Hussain, Amanda Cruz, Ali A. Baaj, Roger Härtl, and Jeffrey P. Greenfield

) and magnetic resonance imaging (MRI) carried out closest to the date of surgery and on imaging approximately 3 months after surgery. For the OCF and VD cohort, pB-C2, ADI, and BDI were collected only preoperatively because of absence of the rostal dens. Measurement of the CXA in postoperative patients with VD was made utilizing the dural margin of the resected dens. Measurements were made by a team of neurosurgeon (N.J.M.) and senior medical student (J.K.C.) who were blinded, at the time of radiographic measurement, to clinical presentation and outcomes. Both were