Arnold-Chiari畸形并脊髓空洞症16例手术治疗

Surgical treatment of 16 cases of Arnold-Chiari malformation complicated by syringomyelia

目的探讨Arnold-Chiari畸形并脊髓空洞症手术治疗的手术方式及效果。方法对16例磁共振成像(MRI)证实的Arnold-Chiari畸形并脊髓空洞症患者的手术治疗情况进行回顾性分析。16例患者均行后颅窝减压术+硬脑膜扩大修补术。结果出院时患者症状明显改善或改善者13例,无改善但病情稳定者2例,恶化者1例,无死亡。随访10例患者,复查MRI脊髓空洞消失或基本消失者8例,缩小者1例,无改变者1例。结论后颅窝减压术+硬脑膜扩大修补术是治疗ChiariⅠ畸形并脊髓空洞症的有效方法。

Objective To discuss the surgical methods and outcomes of Amoid-Chiari malformation complicated by syringomyelia. Methods The surgical outcomes were retrospectively analyzed in 16 cases of Amoid-Chiari malformation complicated by syringomyelia diagnosed by MRI, who were performed on by posterior fossa decompression plus enlarged reconstruction of posterior fossa. Results The clinical signs and symptoms had been markedly improved or improved in i 3 cases until patients were discharged from hospital, unchanged in 2 cases and deteriorated in i case. There was no death in all cases after surgery. During the follow-up from 2 months to 7 years in 10 patients, the MRI findings demonstrated that the cavities in spinal cords disappeared completely or nearly in 8 cases, reduced in 1 case and were unchanged in i case. Conclusion Posterior fossa decompression plus enlarged reconstruction of posterior fossa is an effective method for the treatment of Arnoid-Chiari malformation complicated by syringomyelia.