后颅窝内减压治疗Chiari 畸形Ⅰ型并脊髓空洞中期疗效评价

目的 评价后颅窝内减压(后颅窝减压+后颅窝颅骨成形术)治疗Chiari 畸形Ⅰ型并脊髓空洞疾病的中期临床疗效.方法 采用后颅窝内减压术治疗40 例符合标准的Chiari 畸形Ⅰ型并脊髓空洞.观察手术时间、切口愈合情况,分析相关并发症.采用远期生活质量评估(KPS)和美国Lawton 和Brody1996 年制定的日常生...

Mid-term outcomes of posterior fossa decompression and cranioplasty for Chiari malformation and syringomyelia type I

Objective To evaluate the mid-term outcomes of posterior fossa decompression and cranioplasty for Chiari malformation and syringomyelia type I. Methods Posterior fossa decompression and cranioplasty were performed in a consecutive series of 40 patients. Clinical outcomes were assessed by Karnofsky Performance Scale （KPS） scores and activies of daily living （ADL） questionnaires before and after operation. Operation time, intraoperative blood loss, incision status and complications were recorded. Radiological examination was obtained for each patient to assess the situation of changes in syringomyelia, postoperative cerebrospinal fluid flow rates and the stability of the craniocervical junction. Results The KPS scores increased significantly from （70± 10） preoperatively to （80 ± 10） postoperatively （P 〈 0.01 ）. The ADL scores were decreased remarkably from （20.6 ±2.2） preoperatively to （ 15.8 ±0.5） postoperatively （P 〈0. 01 ） and the proportion with optimal effect was 86%. Syringomyelia narrowing and disappearance rate was 90. 5% （19/21）. Cerebrospinal fluid flow speed improved compared with that before operation. Conclusion Posterior fossa decompression and cranioplasty is an effective and convenient method for Chiari malformation and syringomyelia type I .