大腿阔筋膜在Chiari畸形伴脊髓空洞术中的应用

目的探讨自体大腿阔筋膜治疗Chiari畸形伴脊髓空洞症手术中的应用方法。方法回顾性总结了2001年-2007年该手术模式治疗的12例病人的临床资料。采取后颅窝减压，硬膜切开，显微镜下松解小脑扁桃体粘连，切除下疝的小脑扁桃体，用大腿阔筋膜行后颅窝重建术，空洞不处理。结果12例病人除1例病情稳定症状与手术前无明显改善，其余11例病人临床症状均较手术前明显好转。手术4月后复查MRI，4例空洞消失，6例空洞较手术前缩小，2例空洞无明显变化。12例病人枕大池均重现。结论用自体大腿阔筋膜行后颅窝重建，恢复枕大池的结构和功能。是治疗Chiari畸形伴脊髓空洞症的有效方法，对提高疗效有明显的作用。

Application of Autologous Fascia Lata in Surgical Treatment of Chiari' s Malformation Associated with Syringomyelia

Objective To study the application of autologous fascia lata in surgical treatment of Chiari＇ s malformation associated with syringomyclia. Methods The clinical data of 12 cases undergoing decompression of posterior fossa, dura incision, lysis of tonsillar mucosal tissue adhesions in cerebellum, incision of tonsillar hernia, and posterior fossa Reconstruction with fascia lata from 2001 to 2007 were summarized retrospectively. Results Except one case, all other cases have been significantly improved in clinical symptoms. MRI reexamination after 4 months revealed disappearance of cavitation in 4 cases, shrinkage of cavitation in 6 cases,and cavitation maintained in 2 cases. 12 cases saw reemergence of cisterna magna. Conclusions Reconstruction of the posteriou fossa with fascia lata and the restoration of structure and functions of cisterna magna are effective for Chiari＇ smalformation associated with syringomyelia.