Gürbüz Mehmet Sabri, Berkman Mehmet Zafer, Ünal Emre, Akpınar Elif, Gök Şevki, Orakdöğen Metin, Aydın Salih
Neurosurgery Clinic, Emsey Hospital, Istanbul, Turkey.
Neurosurgery Clinic, Acibadem Hospital, Istanbul, Turkey.
Asian Spine J. 2015 Oct;9(5):721-7. doi: 10.4184/asj.2015.9.5.721. Epub 2015 Sep 22.
Retrospective cohort study.
To compare surgical results of foramen magnum decompression with and without duraplasty in Chiari malformation type 1 (CM-1) associated syringomyelia (SM).
The optimal surgical treatment of CM-1 associated with SM is unclear.
Twenty-five cases of CM-1 with SM were included. There were 12 patients (48%) in the non-duraplasty group and 13 patients (52%) in the duraplasty group. The rate of improvement, state of postoperative SM size, amount of tonsillar herniation, preoperative symptom duration, complications and reoperation rates were analysed.
The rate of clinical improvement was significantly higher with duraplasty (84.6%) than without (33.3%, p <0.05). The rate of postoperative syrinx regression was significantly higher in the duraplasty group (84.6%) than in the non-duraplasty group (33.3%, p <0.05). One case in the duraplasty group needed a reoperation compared with five cases in the non-duraplasty group (p =0.059).
Duraplasty is superior to non-duraplasty in CM-1 associated with SM despite a slightly higher complication rate.
回顾性队列研究。
比较在1型Chiari畸形（CM - 1）合并脊髓空洞症（SM）患者中，行与不行硬脑膜成形术的枕骨大孔减压手术结果。
CM - 1合并SM的最佳手术治疗方法尚不清楚。
纳入25例CM - 1合并SM患者。非硬脑膜成形术组有12例患者（48%），硬脑膜成形术组有13例患者（52%）。分析改善率、术后脊髓空洞大小状态、扁桃体疝程度、术前症状持续时间、并发症及再次手术率。
硬脑膜成形术组临床改善率（84.6%）显著高于非硬脑膜成形术组（33.3%，p<0.05）。硬脑膜成形术组术后脊髓空洞缩小率（84.6%）显著高于非硬脑膜成形术组（33.3%，p<0.05）。硬脑膜成形术组有1例患者需要再次手术，而非硬脑膜成形术组有5例（p = 0.059）。
在CM - 1合并SM的治疗中，尽管并发症发生率略高，但硬脑膜成形术优于非硬脑膜成形术。
