后颅窝扩大重建术促进Chiari畸形合并脊髓空洞症患者上下肢运动及感觉功能恢复

目的观察后颅窝扩大重建术后Chiari畸形合并脊髓空洞症患者上下肢运动及感觉功能的恢复情况,探讨此术式对Chiari畸形合并脊髓空洞症脊髓功能恢复的作用。方法所有患者被分为两组:后颅窝扩大重建术组(posteriorfossareconstruction,PFR组)共56例患者;后颅窝减压术组(posteriorfossadecompression,PFD组)共62例患者。定期随访。按NCSS(NeurosurgicalCervicalSpineScale)定量分析上下肢运动及感觉障碍恢复情况,其结果作统计学分析。结果PFR组的上、下肢和感觉功能的有效率分别为76%,71%,70%;PFD组的上、下肢和感觉功能的有效率分别为58%,60%,66%。两组上下肢及感觉障碍的有效率经χ2检验差异无统计学意义。结论PFR能明显促进Chiari畸形合并脊髓空洞症患者上下肢运动及感觉障碍的功能恢复。

Restoration of motor and sensory functions of upper and lower extremities by posterior fossa reconstruction in patients with Chiari malformation combined with syringomyelia

Aim To explore effect of posterior fossa reconstruction on restoration of spinal cord function by observing the effect of posterior fossa reconstruction(PFR) on functional restoration of spine in patients with Chiari malformation and syringomyelia.Methods 118 patients with Chiari malformation and syringomyelia were divided into 2 groups: Posterior fossa reconstruction(PFR)group(56 patients) and Posterior fossa decompression(PFD)group(62 patients).All the patients were followed up at regular time.Quantitative analysis of the recovery of motor and sensory function in upper and lower extremities according to NCSS (Neurosurgical Cervical Spine Scale) in the two groups had been done. The results were statistically analysed.Results The efficiency rates of the motor function recovery in the upper and lower extremities and the recovery of the sensory disturbance were 76% ,71% ,70% respectively in PFR group and 58% ,60% ,66% in PFD group.The difference of the results in the two groups was not significant according to χ 2 test.Conclusion PFR can promote the recovery of motor and sensory functions of upper and lower extremities in patients with Chiari malformation and syringomyelia.This method may be used as a preferred surgical method in the treatment of the diseases.