Department of Neurosurgery, Primary Children's Medical Center, University of Utah, 100 N. Mario Capecchi Dr, Salt Lake City, UT 84113, USA.
Neurol Sci. 2011 Dec;32 Suppl 3:S345-7. doi: 10.1007/s10072-011-0690-5.
"Complex Chiari" malformations may be defined as cerebellar tonsil herniation combined with one or more of the following radiographic findings: brainstem herniation through the foramen magnum (Chiari 1.5 malformation), medullary kink, retroflexed odontoid, abnormal clival-cervical angle, occipitalization of the atlas, basilar invagination, syringomyelia or scoliosis. Patients with "complex Chiari" malformation are different from those with typical Chiari 1 malformation in that their management strategy has a higher chance of including other operative interventions aside from a typical suboccipital decompression. These other operative procedures include odontoid resection and craniocervical fusion. This paper outlines specific scenarios where these other operative procedures must be considered and carried out.
“复杂 Chiari”畸形可定义为小脑扁桃体疝合并以下一种或多种影像学表现：脑干通过枕骨大孔疝出（Chiari 1.5 畸形）、延髓扭曲、寰椎后弓反折、齿状突异常、斜坡-颈椎角异常、寰椎枕骨化、颅底凹陷、脊髓空洞症或脊柱侧凸。“复杂 Chiari”畸形患者与典型 Chiari 1 畸形患者不同，其治疗策略除了典型的枕下减压术外，更有可能需要其他手术干预。这些其他手术包括齿状突切除术和颅颈融合术。本文概述了必须考虑和实施这些其他手术的具体情况。
