微创小脑扁桃体下疝切除术在小脑扁桃体下疝畸形合并脊髓空洞中的应用研究

The minimally invasive resection under cerebellar tonsillar hernia in Chiari typeⅠclinical curative effect of combination of syringomyelia

目的研究微创小脑扁桃体下疝切除术在小脑扁桃体下疝畸形合并脊髓空洞中的临床疗效。方法选择2013—2018年在郑州市中心医院因小脑扁桃体下疝畸形合并脊髓空洞症手术患者50例,行微创小脑扁桃体下疝切除术。术后1年和2年时参考Tator评分方法进行疗效评价。结果术后1年时随访50例患者,临床症状好转25例、稳定23例、加重2例,磁共振成像(MRI)显示脊髓空洞缩小或完全消失40例、无变化10例;术后2年随访50例患者,临床症状好转30例、稳定17例、加重3例,MRI显示脊髓空洞缩小或完全消失43例、无变化7例。结论微创小脑扁桃体下疝切除术在治疗小脑扁桃体下疝畸形合并脊髓空洞中临床疗效明显,且并发症少、可以推广使用。

Objective To study the minimally invasive resection under cerebellar tonsillar hernia in Chiari typeⅠclinical curative effect of combination of syringomyelia.Methods Choose 2013—2018 in zhengzhou city central hospital for Chiari typeⅠmerger of 50 patients with syringomyelia surgery,minimally invasive resection under cerebellar tonsillar hernia.Intraoperatively,the foramen magnum was opened,part of the atlas was bitten off,the dura mater was cut open,and part of the cerebellar tonsils were excised under the microscope.Efficacy was evaluated 1 and 2 years after surgery using the Tator scoring method.Results The 50 patients were followed up at 1 year after operation,among which 25 had improved clinical symptoms,23 had stabilized symptoms,and 2 had aggravated symptoms.In the follow-up of 50 patients 2 years after the operation,30 patients had improved clinical symptoms,17 patients had stabilized symptoms,and 3 patients had aggravated symptoms.MRI showed 43 patients with reduced or complete disappearance of syringomyelia,and 7 patients had no changes.Conclusion Minimally invasive resection under cerebellar tonsillar hernia in the treatment of Chiari typeⅠmerger of syringomyelia in clinical curative effect obviously,and fewer complications,and can promote the use.