后颅窝小骨窗减压及硬脑膜成形术治疗Chiari畸形Ⅰ型45例疗效分析

Therapeutic effect analysis of small bone flap craniotomy decompression of posterior cranial fossa and duraplasty for 45 patients with Chiari malformation type Ⅰ

目的探讨采用后颅窝小骨窗减压及硬脑膜成形术治疗Chiari畸形Ⅰ型的疗效。方法回顾性分析45例Chiari畸形Ⅰ型患者行后颅窝小骨窗减压及硬脑膜成形术临床资料，其中合并脊髓空洞症31例。结果按Tator等标准，术后1个月优30例，良15例。随访6个月至6年，其中优37例，良8例。31例合并脊髓空洞症患者中有26例脊髓空洞消退，5例脊髓空洞无明显变化。结论后颅窝小骨窗减压及硬脑膜成形术可使颅颈交界区充分减压，并对脊髓空洞症有明显的治疗作用，是治疗Chiari畸形Ⅰ型安全有效的治疗方法。

Objective To evaluate the therapeutic effect of small bone flap craniotomy decompression of posterior cranial fossa and duraplasty in the treatment of Chiari malformation type I . Methods The clinical data of 45 Chiari malformation type Ⅰ patients who were treated with small bone flap craniotomy decompression of posterior cranial fossa and duraplasty were retrospectively analyzed, 31 cases among themwith syringomyelia. Results According to Tator etc. standard, 1 month after surgery,the excellent in 30 cases, good in 15 cases. Follow up from 6 months to 6 years, the excellent in 37 cases, good in 8 cases. Among 31 patients with syringomyelia, 26 cases were syringomyelia subsided,5 cases were not obvious change. Conclusion The small bone flap craniotomy decompression of posterior cranial fossa and duraplasty can make the craniocervical decompression, and has obvious effect of treating syringomyelia, is safe and effective in treatment of Chiari malformation type Ⅰ.