Chiari畸形合并脊髓空洞症的手术治疗

Surgical treatment of 31 cases of chiari I malformation complicated with syringomyelia.

目的探讨chiari畸形合并脊髓空洞症的手术方法及疗效。方法对31例手术患者进行回顾分析,其中28例经MRI证实的chiari畸形合并脊髓空洞症患者行后路枕下减压及小脑扁桃体切除术,3例经MRI与颅骨X线证实的chiari畸形合并颅底凹陷患者行后路枕下减压及寰枕融合术并评定其疗效。结果出院时患者症状明显改善或改善者27例,无改善但病情稳定者4例。随访26例患者,复查MRI脊髓空洞消失或基本消失20例,缩小3例,无变化3例。结论后颅凹减压术,小脑扁桃体切除术,寰枕融合术及其不同组合是治疗chiari畸形合并脊髓空洞症的有效方法。

Objective To discuss the surgical treatment of chiari I malformation complicated with syringomyelia. Methods The surgical treatments of 31 cases were analyzed retrospectively,28 cases for chiari I malformation complicated with syringomyelia being proposed by MRI were performed by posterior fossa decompression and resection of the cerebellar tonsils. 3 cases for chiari I malformation complicated with basilar invagination being proposed by MRI and X rays were performed by posterior fossa decompression and atlanto-ocipitalfussion. Results the clinical signs and symptoms had been markedly improved or improved in 27 cases, uncharged 4 cases, until patients were discharged from hospital. The postoperative MRI finding the 26 cases patients demonstrated that the cavities in spinal cords disappeared completely of nearly in 20 cases, reduced in 3 cases, uncharged in 3cases. Conclusion Posterior fossa decompression, Posterior fossa decompression and resection of the cerebellar tonsils, Posterior fossa decompression and atlanto-ocipitalfussion should be an ef- fective method for treatment of chiari I malformation complicated with syringomyella and chiari I malformation complicated with basilar invagination.