Chiari畸形伴脊髓空洞症的微创手术治疗

目的探讨Chiari畸形并脊髓空洞症的微创外科手术治疗方法。方法回顾性分析74例患者微创手术治疗情况。微创手术治疗74例,均行后颅窝小骨窗减压,下疝小脑扁桃体切除,松解蛛网膜下腔的粘连,开放正中孔至第四脑室及小脑延髓侧池,改善蛛网膜下腔脑脊液循环,原位缝合硬脑膜。结果术后临床症状消失和改善者68例,无变化6例。随访56例,脊髓空洞明显缩小。结论微创手术是治疗Chiari畸形并脊髓空洞症的有效方法。恢复蛛网膜下腔的脑脊液循环是治疗的关键。

Minimally invasive surgical treatment of Chiari malformation associated with syringomyelia

Objective To explore the minimally invasive surgical treatment of Chiari malformation associated with syringomyelia. Methods The minimally invasive operations of 74 patients were analyzed retrospectively. Decompression was achieved by small window eraniotomy and resection of hernia below cerebellar tonsil was performed. The adherence of subarachnoid space with surrounding tissue was removed and the communication of cerebrospinal fluid between the fourth ventricle and subarachnuid space was achieved. Dura was sutured in situ. Results The clinical signs and symptoms improved in 68 cases and no improvement in 6 cases. A total of 56 cases were followed-up from 3 months to 2. 5 years. The MR] finding demonstrated that the cavities in spinal cords disappeared or reduced in 56 cases. Conclusion Minimally invasive surgery is the practical method for Chiari malformation associated with syringomyelia. Restructure of cerebrospinal fluid circulation is the key point in the treatment of Chiari malformation associated with syringomyelia.