Arnold-Chiari畸形143例显微手术治疗经验体会

 目的 探讨Arnold-Chiari畸形手术治疗方法及治疗经验体会。方法  回顾性分析143例Arnold-Chiari畸形患者的临床资料。143 例患者均行枕下减压术，其中95 例行轻划硬膜减压，48 例行自体筋膜扩大重建。全部患者术前均行MRI检查，其中132 例伴发脊髓空洞，24 例伴有寰枢椎脱位、半脱位，颅底陷入、扁平颅底等寰枕畸形。结果   3 例术后死亡，8 例脑脊液漏，近期治疗无效5 例。117 例获得随访，随访3 个月~6 年，平均随访2.5 年，痊愈67 例，好转33 例，远期治疗无效17 例，一期行经口齿状突切除-枕颈内固定者7 例，行单纯枢枕植骨融合者4 例。结论  枕下减压自体筋膜修补扩大重建是目前最为行之有效的方法，对于颅颈交界区的稳定性必须给予充分的重视。

Microsurgical Treatment Experiences and Understandings of 143 Arnold-Chiari Malformations

Objective To investigate the microsurgical approach and therapy experiences as well as the understandings of Arnold-Chiari malformation.Methods The clinical data of 143 cases of Chiari malformation were analyzed retrospectively;they were performed by posterior fossa decompression,among whom light-cutting on dura were performed in 95 cases,and others were reconstructed using autologous fascia.MRI showed that 132 cases were accompanied by syringomyelia,24 cases accompanied by other antalo-occipital malformati...