ChiariI型畸形微创后颅窝减压术

Role of minimally invasive posterior fossa decompression in the surgical treatment of Chiari I malformation

目的探讨微创后颅窝减压术对ChiariI型畸形的治疗效果及手术并发症发生率。方法将自2006年1月至2009年1月接受微创后颅窝减压术的32例患者设为治疗组．自2001年1月至2005年12月接受传统后颅窝减压术的35例患者设为对照组．比较2组患者的治疗结果、手术并发症发生率等。结果2组患者的治疗结果、术后脊髓空洞的变化差异均无统计学意义（P〉0．05）。2组手术并发症发生率分别为6．3％和31．4％，治疗组明显低于对照组，差异有统计学意义（X2=6．777，P=0．009）。结论微创后颅窝减压术对ChiariI型畸形的治疗效果与传统后颅窝减压术相当，而手术并发症相对较少。

Objective To explore the effect of minimally invasive posterior fossa decompression in the surgical treatment of Chiari I malformation and its surgical complications. Methods A controlled trial was conducted in 67 patients with Chiari I malformation. Among them, 32 patients （treatment group） underwent minimally invasive posterior fossa decompression, while the other 35 patients （control group） underwent traditional posterior fossa craniotomy. Surgical outcomes and complications were compared between these 2 groups. Results No statistic difference in the surgical outcomes and the changes ofsyringomyelia between the 2 groups were found （P〉0.05）. The rate of the surgical complications in the treatment group （6.3%） was significantly lower than that in the control group （[31.4%], x2=-6.777, P=-0.009）. Conclusion The effect of minimally invasive posterior fossa decompression in the treatment of Chiari I malformation is similar to that of traditional posterior fossa craniotomy; however, the former one has significantly less surgical complications than the later one.