后颅窝减压硬脑膜成形治疗Chiari畸形合并脊髓空洞症

Effects of posterior fossa decompression and duraplasty on Chiari malformation associated with hydromyelia

目的探讨后颅窝减压硬脑膜成形手术治疗脊髓空洞症合并Chiari畸形的治疗方法及效果。方法27例Chiari畸形并脊髓空洞症经MRI确诊后应用显微外科技术,采用减压硬脑膜成形术,并进行3个月以上随访以判断治疗效果。结果27例患者术后症状均有不同程度的改善,术后复查头颅MRI见脊髓空洞缩小。结论该手术可使颅颈交界区充分减压,改善了脑脊液循环状态,有效地缓解了临床症状,并对脊髓空洞有明显的治疗作用。扩大修补硬脑膜有利于减少术后并发症的发生。

Objective To explore the surgical procedure of posterior fossa decompression and duraplasty for the treatment of Chiari malformation associate with syringomyelia using microsurgical technique. Methods Twenty-seven patients with chiari malformation associated with syringomyelia confirmed by CT or MRI were analyzed retrospectively. The patients underwent posterior cranial fossa decompression with microsurgery. All the patients were followed up for more than 3 months and the treatment results were evaluated. Results The symptoms improved with different degree after operation in 27 cases. Three-month follow-up MRI showed a decrease of the syringomyelia. Conclusion Sufficient decompression at the craniocervica junction by the surgical procedure may ameliorate the behavior of the cerebro-spinal fluid circulation and reverse the symptoms and syringomyelias. Enlarged reconstruction the posterior fossa may decrease the postoperative complications.