颅底畸形合并颈胸段脊髓空洞症的显微手术及术后康复治疗

Microsurgical Treatment and Postoperative Rehabilitation of Patients with Basilar Impression Malformation Accompanied with Cervicothoracic Junction Syringomyelia

目的 :探讨颅底畸形合并脊髓空洞症的手术方式、康复方法及术后神经功能康复的影响因素。方法 :分析 1999年 9月～ 2 0 0 3年 9月 2 6例颅底畸形合并脊髓空洞症患者的术前脊髓功能状态、手术方式、康复方法及术后功能恢复等情况。结果 :术前JOA评分 8～ 12分 ,平均 9.7分。治疗后随访 6-48个月 ,JOA评分 15～ 17分 ,平均 16分 ,恢复率 80 %～ 10 0 % ,平均 93 .6%。结论 :颅底畸形合并脊髓空洞症长期手术效果确切 ;早期诊断、术前脊髓功能状态、适时外科干预。

Objective: To explore the surgical pro cedures, rehabilitative methods and the influencing factors for postoperative ne ural function recovery in basilar impression malformation accompanied with cervi cothoracic junction syringomyelia. Methods: The spinal function, surgical proced ures, rehabilitative methods and postoperative function recovery in 26 patients with basilar impression malformation accompanied with syringomyelia from Septemb er 1999 to October 2003 were analyzed. Results: The Japanese Orthopaedic Associ ation (JOA) scores before operation was 8～12(mean 9.7). During a follow-up of 6～48 months after operation, the JOA scores were 15～17 (mean 16). The recov ery rate was 80 % to 100 % (mean 93.6 % ). Conclusion: The long-term results of s urgical treatment on basilar impression malformation accompanied with syringomye lia were definite. The timing of operation, early diagnosis, degree of pathology , surgical procedures and rehabilitative methods influence the treatment results greatly.