Kato Naoki, Tanaka Toshihide, Nagashima Hiroyasu, Arai Takao, Hasegawa Yuzuru, Tani Satoshi, Abe Toshiaki
Department of Neurosurgery, Jikei University School of Medicine Kashiwa Hospital, Kashiwa, Chiba.
Neurol Med Chir (Tokyo). 2010;50(2):172-4. doi: 10.2176/nmc.50.172.
A 50-year-old woman presented with nuchal pain, clumsiness in both hands, and gait disturbance. Cervical magnetic resonance (MR) imaging showed cervical canal stenosis at C3-C7 levels associated with a syrinx and cerebellar tonsillar herniation. The patient underwent C3-C7 laminoplasty. Her symptoms improved completely, and the patient was discharged 10 days after operation. Postoperative MR imaging showed disappearance of the syrinx. This case suggests that cerebellar tonsillar herniation may not cause syringomyelia. Posterior decompression, such as laminectomy and laminoplasty, without foramen magnum decompression may be an appropriate surgical strategy for diffuse cervical canal stenosis associated with syringomyelia below the narrow canal, even in the presence of co-existing Chiari malformation.
一名50岁女性出现颈部疼痛、双手笨拙及步态障碍。颈椎磁共振成像显示C3 - C7水平的椎管狭窄，伴有脊髓空洞症及小脑扁桃体疝。患者接受了C3 - C7椎板成形术。其症状完全改善，术后10天出院。术后磁共振成像显示脊髓空洞症消失。该病例提示小脑扁桃体疝可能不会导致脊髓空洞症。对于狭窄椎管以下伴有脊髓空洞症的弥漫性颈椎管狭窄，即使存在合并的Chiari畸形，不进行枕骨大孔减压的后路减压术，如椎板切除术和椎板成形术，可能是一种合适的手术策略。
