脊髓中央管隔膜形成与Chiari畸形并脊髓空洞

Formation of dissepiment of central canal and Chiari's malformation associated with syringomyelia

目的 探讨显微外科治疗Chiari畸形并脊髓空洞的手术方法。方法 127例Chiari畸形并脊髓空洞经MRI确诊,采用小脑扁桃体下疝切除,并脊髓中央管开口隔膜切开术。结果 术中发现脊髓中央管开口隔膜形成;术后随访89例,MRI检查示,所有患者下疝的小脑扁桃体均消失,并存脊髓空洞明显缩小和消失。结论 小脑扁桃体下疝,脊髓中央管开口隔膜形成是造成Chiari畸形并脊髓空洞的原因之一;小脑扁桃体下疝切除,脊髓中央管隔膜切开术是手术治疗Chiari畸形并脊髓空洞症的有效方法。

Objective To discuss the microsurgical therapeutic strategy of the Chiari's malformation associated with syringomyelia.Methods One hundred and twenty-seven cases which showed the symptoms of the Chiari's malformation associated with syringomyelia were confirmed by MRI. The hernia of tonsilla cerebelli was removed and the dissepiment that located in the mouth of the central canal of spinal cord was opened.Results All cases with Chiari's malformation associated with syringomyelia were found that the dissepiment was located in the mouth of the central canal of spinal cord. The hernia of tonsilla cerebelli of eighty-nine cases disappeared and syringomyelia decreased or disappeared through the average 1.5 years' follow-up.Conclusion The hernia of tonsilla cerebelli and the dissepiment located in the mouth of the central canal of spinal cord is one of the important reasons for the Chiari's malformation associated with syringomyelia. Removing the hernia of tonsilla cerebelli and opening the dissepiment that located at the mouth of the central canal of spinal cord are the practical method in treatment of the Chiari's malformation associated with syringomyelia.