Wang Zuowei, Wang Xingwen, Jian Fengzeng, Zhang Can, Wu Hao, Chen Zan
Department of Neurosurgery, Division of Spine, China International Neurological Institute, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.
Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China.
Eur Spine J. 2017 Apr;26(4):1019-1027. doi: 10.1007/s00586-016-4740-9. Epub 2016 Aug 23.
The purpose of this study focuses on the changes of the syrinx volume after posterior reduction and fixation of the basilar invagination (BI) and atlantoaxial dislocation (AAD) with syringomyelia.
We retrospectively analyzed the clinical outcome and syrinx volume changes in 71 patients with BI, AAD and syringomyelia treated with the posterior reduction and fixation technique.
Clinical improvement was observed in 64 (90.1 %) patients postoperatively; 5 (7.0 %) were stable and 2 (2.8 %) were clinically aggravated. The postoperative Atlantodental interval became normal in 61 patients (86.0 %); showed reduction that was greater than 50 % but not complete in 5 patients (7.0 %); and reduction which was less than 50 % in 5 patients (7.0 %). The size of the syrinx was reduced postoperatively in 66 patients (93.0 %) while no change in the remaining 5 patients (7.0 %).
Posterior reduction and fixation of the AAD and BI can effectively enlarge the foramen magnum, improve the cerebrospinal fluid circulation and consequently reduce the volume of the syrinx.
本研究旨在关注伴有脊髓空洞症的基底凹陷症（BI）和寰枢椎脱位（AAD）行后路复位及固定术后脊髓空洞体积的变化。
我们回顾性分析了71例采用后路复位及固定技术治疗的BI、AAD合并脊髓空洞症患者的临床疗效及脊髓空洞体积变化。
术后64例（90.1%）患者临床症状改善；5例（7.0%）病情稳定；2例（2.8%）临床症状加重。术后61例（86.0%）患者寰齿间隙恢复正常；5例（7.0%）患者寰齿间隙缩小超过50%但未完全恢复正常；5例（7.0%）患者寰齿间隙缩小不足50%。66例（93.0%）患者术后脊髓空洞体积缩小，其余5例（7.0%）无变化。
AAD和BI的后路复位及固定可有效扩大枕大孔，改善脑脊液循环，从而减小脊髓空洞体积。
