颅底凹陷症合并脊髓空洞症的显微外科治疗

MICRONEUROSURGICAL TREATMENT OF BASILAR IMPRESSION ACCOMPANIED WITH SYRINGOMYELIA

目的 :分析 76例颅底凹陷症合并脊髓空洞症的显微外科手术治疗效果 ,探讨发病机理与手术方法等。方法 :采用显微外科手术方法 ,分别行枕下减压 (A)、空洞蛛网膜下腔分流 (B)、四脑室闩部疏通术 (C) ,按Tator标准进行评定 ,观察不同手术方法后的效果。结果 :76例均有效 ,其中 9例Ⅰ期手术行A后效果不明显 ,又Ⅱ期手术行B后仅 1例症状无改善 ;5 2例同时行A +B后 ,仅 2例症状无改善 ;15例同时行A +B +C后效果均为优。结论 :仅行A后难以奏效 ,A +B +C是最有效的手术方法。

Objective:To report operations on 76 cases of basilar impression accompanied with syringomyelia,and to explore the pathogenisis,operation methods,and better prognosis.Methods:Using microneurosurgical treatment method,results of different operation method were obtained according to Tator′s criteria.Results:All the 76 cases were good,9 of them used suboccipito decompression(A)first,but the results were not good,then syringo subarachnoid shunt(B) were done,the results were much better,only one case no better but no worse.Fifty two of them used A+B+C(the belt or latch of the fourth ventricle dredged),good results were obtained.Conclusion:Only method A can not obtained good results,method combination A+B+C is best for the operation.