Chiari畸形的手术治疗

Operative treatment of Chiari malformation and its clinical significance.

目的 探讨Chiari畸形的手术方法及疗效。 方法 回顾 12 8例Chiari畸形患者行MRI矢状位T1WI、T2 WI扫描 ,采用单纯颅后窝及C1、C2减压术或颅后窝及C1、C2减压加硬膜成形术。 结果 结合MRI特征 ,对 96例伴有脊髓空洞的患者和 13例无脊髓空洞但术中见有明显硬膜束带的患者 ,行颅后窝、C1、C2减压加硬膜成形术 ,对 19例无脊髓空洞但临床症状进行性加重者 ,行单纯颅后窝、C1、C2减压术 ,总有效率为 92 %。 结论 Chiari畸形的治疗应结合MRI特征 ,采取不同的手术方式 ,可达到良好的效果。

Objective To elucidate the effect of operational method on Chiari malformation and clinical significance. Methods 128 Chiari malformation patients were respectively reviewed and scanned by using preoperational MRI at sagittal T 1WI and T 2Wl, and treated with decompression of posterior cranial fossa,C1 and C2,or with decompression of posterior cranial fossa, C1 and C2 plus dural plastic operation. Results Of the 128 patients, 96 cases with syringomyelia and 13 cases without syringomyelia but with duro-bander were treated with decompression at the posterior cranial fossa, C1 and C2 plus dural plastic operation, 19 cases without syringomyelia but with increased syndrome were treated with decompression at posterior cranial fossa, C1 and C2.The different operation were performed according to the MRI characteristics,and the operation result was satisfactory(92%). Conclusion Different operational methods can be chosen for treatment of chiari malformation patients in combination with MRI and satisfyactory results can be achieved.