Yilmaz Nebi, Kiymaz Nejmi, Mumcu Ciğdem
Neurosurgery Department of Medical School, Yuzuncu Yil University, Van, Turkey.
Hiroshima J Med Sci. 2005 Dec;54(4):109-11.
We aimed to describe a patient without Chiari malformation who was treated via craniocervical decompression and by creating cisterna manga with an autologous fascia graft, and who displayed a clinical and radiological improvement in the post-operative period. Syringomyelia is a chronic and progressive disease with cavitation and gliosis in the spinal cord. It is more common in adulthood and often involves the cervical region. Due to the fact that craniocervical decompression therapy is successful in syringomyelia with Chiari malformation, this surgical treatment is currently controversial in syringomyelia without Chiari malformation. A 33-year-old male applied to our clinic with numbness and weakness in his left hand that had lasted for 2 years, but his condition had worsened in recent months, with neck pain before over previous the 8 months and a walking disturbance that had appeared 7 months before. Syringomyelia was found between the C2 and T8 vertebrae levels on magnetic resonance imaging (MRI) scans. The patient was diagnosed with syringomyelia and underwent suboccipital decompression. Cisterna magna was created by duraplasty with a fascia lata graft. Consequently, craniocervical decompression might be accepted as a treatment method of choice in patients with syringomyelia without Chiari malformation.
我们旨在描述一名无Chiari畸形的患者,该患者通过颅颈减压术并使用自体筋膜移植片形成枕大池进行治疗,且在术后临床症状和影像学表现均有改善。脊髓空洞症是一种脊髓出现空洞和胶质增生的慢性进行性疾病。它在成年期更为常见,且常累及颈部区域。由于颅颈减压疗法在伴有Chiari畸形的脊髓空洞症中取得成功,目前这种手术治疗在无Chiari畸形的脊髓空洞症中存在争议。一名33岁男性因左手麻木和无力持续2年前来我院就诊,但其病情在最近几个月有所恶化,在过去8个月中有颈部疼痛,7个月前出现行走障碍。磁共振成像(MRI)扫描显示在C2和T8椎体水平之间存在脊髓空洞症。该患者被诊断为脊髓空洞症并接受了枕下减压术。通过阔筋膜移植进行硬脑膜成形术来形成枕大池。因此,颅颈减压术可被视为无Chiari畸形的脊髓空洞症患者的一种首选治疗方法。