Arnold-Chiari畸形合并脊髓空洞症的显微外科手术治疗

目的：总结54例Chiari畸形合并脊髓空洞症的显微外科手术治疗经验。方法：本组对1998年9月至2005年9月共收治的54例Chiari畸形合并脊髓空洞症患者采用后路手术入路，对颅底凹陷症采用后路减压，显微镜下行小脑扁桃体软膜下部分切除，正中孔开放手术治疗。结果：54例患者术中观察发现延髓和上颈髓明显受压和不同程度同小脑扁桃体粘连，正中孔引流不畅；随访1月～7年，术后42例症状显著改善，12例明显改善；影像学复查提示脊髓空洞明显缩小。结论：显微外科手术治疗Chiari畸形合并脊髓空洞症疗效确切可靠。

Microsurgical Treatment for Arnold-Chiari Malformation with Syringomyelia

Objective：To summarize the treatment experience of the microsurgical operation on 54 cases of Arnold- Chiari malformation with syringomyelia. Method： Fifty-four cases of Arnold-Chiari malformation with syringomyelia weceadmit-ted since 1998,9 to 2005,9 were treated by microsurgical operation through posterior pathway operation,and posterior pathway decompression were performed to patients with cranial base depression symptom. Cerebellar amygdalae were partially resected and median foramen obstruction were relieved under microscope. Result： Different grade Pressing of and aelbesion with cerebellar amygdalae of medulla and wpper cervical spinal cord were observed in 54 cases, and different obstruction of median foramen were observed. After 1 month- 7years follow-up by imaging examination, syringomyelia were reduced remarkably on 42 cases,and obviously 12 cases. Conclusion：Microsurgical treatment for Arnold-Chiari malformation with syringomyelia wae effeetive and credibile.