有限小骨窗后颅凹减压显微术式治疗Chiari Ⅰ型畸形

目的 探讨采用有限小骨窗后颅凹减压显微术式治疗Chiari I型畸形的疗效. 方法 成都军区总医院神经外科自2004年至2008年采用有限小骨窗后颅凹减压显微术式治疗Chiari Ⅰ型畸形患者29例.标准手术程序包括有限小骨窗枕颈减压,硬膜扩大成形、硬膜下探查术、硬膜扩大修补等.按照Tator标准评价患者手术治疗的预后情况. 结果 本组患者手术效果评价优23例(79.3%),良6例(20.7%).远期随访患者15例,患者脊髓空洞进一步缩窄9例,复发1例.结论有限小骨窗后颅凹减压显微术治疗Chiari Ⅰ型畸形创伤小,疗效显著.

Treatment of Arnold-chiari I malformation by limited posterior fossa decompression

Objective To explore the effect of limited posterior fossa decompression(LPFD)in the treatment of Amold-chiari I malformation.Methods A retrospective analysis was conducted among 29 patients undergoing LPFD from 2004 to 2008.The standard surgical procedures included small osseous decompression of the occipital bone above the forarnen magnum,removal of the posterior arch of the atlas,separation of the arachnoid adhesions,and reduction of the inferior cerebellar tonsils,a dural graft for duraplasty.The outcomes of the surgeries were evaluated using the Tator criteria.Results Excellent results were obtained in 23(79.3%)patients according to the Tator scores,and good results were achieved in 6(20.7%)patients.During the follow-up of 15 patients,the syrmgomyelia was found to be further reduced in 9 patients,and 1 patient experienced recurrence.Conclusion Limited posterior fossa decompression is effective for management of Amold-chiari I malformation with minimal invasiveness and complications.