枕大池成形术治疗Chiari畸形合并脊髓空洞症

Plastic repairing of the cistern magna to treat the Chiari malformation complicated with syringomyelia

目的 回顾性分析枕大池成形术治疗Chiari畸形合并脊髓空洞症的疗效.方法 采用枕大池成形术（后颅凹减压＋硬脑膜成形＋小脑扁桃体切除＋蛛网膜粘连松解）治疗17例Chiari畸形合并脊髓空洞症患者.对其近期疗效和远期疗效进行总结.结果 近期疗效：17例患者术后临床症状消失或改善15例（有效率为90%）,MRI检查提示下疝扁桃体消失,脊髓空洞缩小.远期疗效：MRI检查提示枕大池成形,脊髓空洞消失或明显变细,脊髓蛛网膜下腔增宽.治疗有效12例（有效率70%）.结论 枕大池成形术治疗Chiari畸形合并脊髓空洞症效果满意,是一种较为合理的治疗方法.

Objective To evaluate retrospectively the efficacy of cistema magna plastic repair in the treatment of Chiari malformation complicated with syringomyelia Methods Fifty-one patients suffered from Chiari malformation complicated with syringomyelia were treated in our department from May 2004 to October 2009. Seventeen patients received cistema magna plastic repairment （the decompression of posterior cranial fossa, duraplastic repair,resection of hernia below cerebellar tonsil and separation of adherence of arachnoid membrane）. Results Clinical symptoms disappeared or improved in 15 cases （effective rate of 90%）. MRI showed tonsillar herniation disappeared,syringomyelia narrow. MRI showed cistema magna plastic repair, syringomyelia disappeared or significantly thinned and spinal cord subarachnoid space widened. Effective treatment obtained in 12 cases （effective rate 70%）. Conclusions The efficiency of Cistern magna plastic repair treating Chiari malformation with syringomyelia is satisfied.