Bao C S, Liu L, Wang B, Xia X-G, Gu Y J, Li D J, Zhan S L, Chen G L, Yang F B
Department of Neurosurgery, The Affiliated Hospital of Luzhou Medical College, Luzhou, Sichuan Province, China.
Department of Neurosurgery, The Affiliated Hospital of Luzhou Medical College, Luzhou, Sichuan Province, China
Genet Mol Res. 2015 Feb 3;14(1):952-60. doi: 10.4238/2015.February.3.2.
This study aimed to investigate the therapeutic effects of craniocervical decompression with duraplasty and cerebellar tonsillectomy for the treatment of Chiari malformation-I with syringomyelia (CM I-SM). From January 2005 to December 2011, 127 patients with CM I-SM underwent craniocervical decompression with duraplasty and cerebellar tonsillectomy and the therapeutic effects of these surgeries were evaluated using Tator scores. No patient in this study died or showed disease deterioration after the surgery. Re-examination by magnetic resonance imaging (MRI) showed that the cisterna magna was obviously larger after the operation in all but one patient. Moreover, syringomyelia (SM) was reduced in 76 patients. CM I-SM symptoms disappeared or decreased in 112 patients after following discharge. Follow-up was conducted in 84 of the patients and 79 of these patients exhibited improved symptoms. A second MRI re-examination showed that the cisterna magna was successfully constructed in 44 patients; 42 of these patients showed further eliminated or obviously reduced SM. Craniocervical decompression with duraplasty and cerebellar tonsillectomy achieved favorable therapeutic effects. Thus, craniocervical decompression with duraplasty and cerebellar tonsillectomy is a rational surgical approach with beneficial clinical effects. The proposed approach may have useful applications in the treatment of CM I-SM.
本研究旨在探讨颅颈减压术联合硬脑膜成形术及小脑扁桃体切除术治疗 Chiari 畸形 I 型伴脊髓空洞症（CM I-SM）的疗效。2005 年 1 月至 2011 年 12 月，127 例 CM I-SM 患者接受了颅颈减压术联合硬脑膜成形术及小脑扁桃体切除术，并使用 Tator 评分评估这些手术的疗效。本研究中无患者术后死亡或病情恶化。磁共振成像（MRI）复查显示，除 1 例患者外，其余所有患者术后枕大池明显增大。此外，76 例患者的脊髓空洞症（SM）有所减轻。112 例患者出院后 CM I-SM 症状消失或减轻。对 84 例患者进行了随访，其中 79 例患者症状改善。第二次 MRI 复查显示，44 例患者成功构建了枕大池；其中 42 例患者的 SM 进一步消除或明显减轻。颅颈减压术联合硬脑膜成形术及小脑扁桃体切除术取得了良好的治疗效果。因此，颅颈减压术联合硬脑膜成形术及小脑扁桃体切除术是一种合理的手术方法，具有有益的临床效果。该方法可能在 CM I-SM 的治疗中具有实用价值。
