Arnold-Chiari畸形合并脊髓空洞症的外科治疗(附32例报告)

目的：探讨Chiari畸形合并脊髓空洞症的手术治疗方法。方法：分析我科收治的32例Chiari畸形合并脊髓空洞症患者进行手术治疗，以后颅窝减压、小脑扁桃体切除、脊髓空洞穿刺、松解四脑室正中孔蛛网膜粘连为主，达到解除后脑受压，解除粘连，恢复枕大孔区CSF循环通畅的目的。结果：随访24例患者中，临床症状完全消失18例，好转2例，术前有头痛、颈痈或肩臂病症状者均有显著减轻，3例自觉症状无变化，复查MRI显示21例空洞明显缩小。结论：后颅窝减压、松解四脑室正中孔蛛网膜粘连，恢复枕大孔区CSF循环通畅是手术治疗Chiari畸形合并脊髓空洞症的关键。

Surgical treatment of Arnold-Chiari malformation with syringomyelia

Objective: To explore the more effective surgical treatment of syringomyelia in Arnold Chiari maformation Methods: The surgical treatments of 32 cases of syringomyelia in Arnold Chiari malformation in this department during January 1996 to January 2002 The surgical treatments, include posterior fossa decompression, cerebellum tonsillectomy, puncture and drainage for syringomyelia, relieve the adhesions of arachno in order to recovery the circulation of cerebrospinal fluid around the foramen magnum Results: Twenty four patients were follow up There were 18 patients with symptom extinction and 2 patients with symptom improve The most patients with headache and pain of neck and shoulde relieved significantly after operation Only 3 patients without improvement The syringomyelia were decreased size displayed by MRI, in 21 patients Conclusion: Posterior fossa decompression, cerebellum tonsillectomy, puncture and drainage for syringomyelia, relieve the adhesions of arachno are the key point of surgical treatment of syringomyelia in Arnold Chiari maformation