前后路联合治疗颅底凹陷合并小脑扁桃体下疝患者的临床疗效及预后分析

Effect and prognosis of anterior posterior surgery on treatment of patients with the basilar invagination complicated with Chiari malformation

目的分析前后路联合治疗颅底凹陷合并小脑扁桃体下疝(Chiari)畸形患者的临床疗效及预后。方法选取2009年2月~2016年2月诊治的12例颅底凹陷症合并Chiari畸形患者。分析患者术后的临床疗效、影像参数变化及预后。结果所有患者术后随访7 d至20个月,患者的临床症状、体征均有明显的改善;术后的JOA评分(14.14±2.04)分明显高于术前的JOA评分(6.65±1.23)分(P<0.05);12例患者术后CL值、ML值、WL值、Klaus高度指数、延颈髓角及颅底角参数较术前明显改善(P<0.05);术后并发症少。结论经前后路联合治疗颅底凹陷合并小脑扁桃体下疝患者的临床效果较好,对脊髓功能改善明显,并发症发生率少,短期预后良好。

Objective To analyze the clinical effect and prognosis of anterior posterior surgery on treatment of patients with the basilar invagination complicated with Chiari malformation.Methods Twelve cases of skull base depression complicated with Chiari malformation treated in our hospital from February 2009 to February 2016 were selected to analyze the clinical efficacy,changes in imaging parameters,and prognosis of patients before and after operation.Results All patients were followed up for 7 days to 20 months,and the clinical symptoms and signs of postoperative patients were significantly improved.The postoperative JOA score(14.14±2.04)was significantly higher than the preoperative JOA score(6.65±1.23)(P<0.05).It was significantly improved for the postoperative CL value,ML value,WL value,Klaus height index,cervicomedullary angle and cranial base angle parameters compared to the preoperative parameters in 12 patients with fewer postoperative complications(P<0.05).Conclusions The clinical results of the combined anterior and posterior approach to the skull base depression complicated with Chiari were significantly improved with spinal cord function.The incidence of complications was low and the short-term prognosis was good.