脊髓空洞症的外科治疗

The surgical treatment of syringomyelia

目的 探讨脊髓空洞症的发病机制、临床特点及外科治疗方法。方法 回顾性分析 1990～ 2 0 0 1年本科手术治疗的 5 1例脊髓空洞症 ,男性 2 4例 ,女性 2 7例 ,年龄 9～ 6 0岁 (平均 31 8岁 )。术前均行MRI检查 ,其中伴枕大孔区病变 46例(Chiari畸形 45例 ) ,不伴枕大孔区病变 5例。结果 术后随访 6个月～ 7年 ,症状改善 33例 ,病情稳定 16例 ,症状加重 2例 ,无死亡 ,总有效率 96 1%。结论 脊髓空洞症与枕大孔区病变密切相关 ,对病情进展的脊髓空洞症首选手术治疗 ,手术方式应根据相关病因及影像学资料来选择。

Objective To discuss the pathogenesis,clinical features and surgical treatment of syringomyelia.Methods 51 patients with syringomyelia who underwent surgical treatment from 1990 to 2001 were analyzed retrospectively.There were 24 males and 27 females with ages ranged from 9 to 60 (mean 31.8) years.MRI were obtained preoperatively in all the patients.There were 46 cases with lesions of foramen magnum( 45 cases with Chiari malformations),5 cases without anomalies at foramen magnum.Results Improvement of clinical symptoms were obtained in 33 cases and symptoms stablized in 16 cases postoperatively.Only 2 cases got worse after operative.Effective result were obtained in 96.1% patients.Conclusion The pathogenesis of syringomyelia is related to lesions of foramen magnum.Surgical treatment should be underwent in patients with progressive symptoms.Methods of operation must be selected based on causitive mechanism and imaging cateria.