Chiari畸形/脊髓空洞伴发脊柱侧凸的临床治疗

Diagnosis and treatment of Chiari malformation and syringomyelia complicated with scoliosis

目的探讨Chiari畸形/脊髓空洞伴发脊柱侧凸的临床诊治,并分析手术疗效。方法 16例Chiari畸形/脊髓空洞伴发脊柱侧凸患者的治疗方案分为两组:A组后颅窝减压/脊髓空洞引流术加支具矫形(6例);B组后颅窝减压/脊髓空洞引流术加脊柱侧凸手术矫形(10例)。结果全部手术均顺利完成,术后无神经并发症,术后恢复平稳;患者的肌力,痛温觉均有不同程度的好转,脊髓空洞缩小,A组脊柱侧凸畸形无明显加重,B组脊柱侧凸平均矫正率胸弯73.2%,腰弯61.7%。矫正率丢失小。结论 Chiari畸形/脊髓空洞伴发脊柱侧凸一期或短时间内分期行后颅窝减压/脊髓空洞引流术加脊柱侧凸矫形术是可行的。不增加神经并发症的发生率,不会影响矫形的结果。

Objective To discuss the diagnosis and treatment of Chiari malformation and syringomyelia complicated with scoliosis and to explore the possible benefits of simultaneous surgical correction of complicated scoliosis. Methods 16 patients was flow-up after treatment, among them 10 had simultaneous surgical correction of scoliosis while the other 6 had postoperative bracing. Results Operation went smoothly in all 16 cases, no neurological complication occurred and recoveries were all satisfy- ing. At the final follow-up, we observed improvements in motor and sense function for all patients. For patients underwent surgical correction, average corrective rate is 73% for thoracic spine and 61.7% for lumber. Conclusion Simultaneous surgical correction after decompressive and shunting procedures is feasible for treating Chiari malformation and syringomyelia complicated with scoliosis. It does not increase the risk of neurological complications and has good correction results.