显微外科治疗Arnold-Chiari氏畸形Ⅰ型38例临床分析

目的探讨Chiari Ⅰ型畸形伴脊髓空洞显微外科治疗方式及效果。方法38例患者均采用枕大池成形术,其中29例采用长切口枕鳞部大骨窗,9例小切口小骨窗。结果术后有效者33例,采用不同手术方式的有效病例分别为长切口大骨窗25例、小切口小骨窗8例,统计学方面无明显差别。结论Chiari Ⅰ型畸形采用枕大池成形术可取得良好效果,小切口枕鳞部小骨窗可减小对患者的手术创伤,降低术后并发症,达到微创的目的。

Clinical analysis of 38 cases of type I Arnold-Chiari malformation with microsurgery

Objective To discuss the effects of different surgical approaches in the treatment of type I Chiari malformation with syringomyelia. Methods 38 cases of type I Chiari malformation with syringomyelia were treated with reconstruction of the cistern magna. 29 cases performing long incision with large bone resection, while 9 cases performing short incision with small bone resection by microsurgery technique. Results Postoperative improvements were achieved in 33 patients, 25 cases of them performing large bone resection, and other 8 cases performing small bone resection. No significant difference was found between these two surgical approaches. Conclusions Reconstruction of the cistern magna is an effective method in the treatment of type I Chiari malformation. Small surgical approach using microsurgery technique could result in reduced surgical damage and postoperative complication.