两种不同手术方法治疗合并脊髓空洞的ChiariⅠ畸形的效果比较

Comparison between curative effects of two different microsurgical methods on Chiari Ⅰ malformation accompanied with syringomyelia

目的探讨合并脊髓空洞的ChiariⅠ畸形的手术治疗方法。方法 2007年1月至2009年12月,收治的ChiariⅠ畸形合并脊髓空洞的19例患者作为观察组,在显微镜下进行小脑扁桃体下疝切除+脊髓中央管口松解+枕下减压扩大硬脑膜修补术治疗。同时搜集2002年1月至2006年12月收治的ChiariⅠ畸形合并脊髓空洞的21例患者作为对照组,单纯采用枕下减压扩大硬脑膜修补术治疗,分析两组的临床效果。结果观察组症状缓解优良率为100.0%(19/19),对照组为52.4%(11/21),两组相较,差异显著(P<0.01)。结论应用显微手术进行小脑扁桃体下疝切除+脊髓中央管口松解+枕下减压扩大硬脑膜修补术治疗ChiariⅠ畸形合并脊髓空洞临床效果好,值得推广。

Objective To study the curative effect of different microsurgical methods on chiari Ⅰ malformation accompanied with syringomyelia. Methods Nineteen patients with Chiari Ⅰmalformation accompanied with syringomyelia serving as observed group were treated by the cerebellar tonsillectomy, central canal opening and extensive posterior fossa decompression with duraplasty from January, 2007 to December, 2009. Twenty-one patients with Chiari Ⅰ malformation accompanied with syringomyelia serving as control group were treated by posterior fossa decompression with duraplasty from January, 2002 to December, 2006. The curative effect in both the groups were analyzed and compared. Results The rate of the symptoms improvement （100%, 19/19） was significantly higher in the treatment than that （52.4%, 11/21） in the control group （P0.05）. Conclusion The cerebellar tonsillectomy, central canal opening and extensive posterior fossa decompression with duraplasty can improve the prognosis in the patients with Chiari Ⅰ malformation accompanied with syringomyelia.