Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
Childs Nerv Syst. 2022 Aug;38(8):1621-1624. doi: 10.1007/s00381-021-05442-y. Epub 2022 Jan 6.
Although foramen magnum decompression (FMD) is effective for the treatment of Chiari malformation type I (CM1), reoperations may be required in cases of insufficient decompression. We encountered a patient who experienced restenosis due to regeneration of resected C1 laminae and required reoperation after FMD.We present the case of a 14-year-old boy with symptomatic CM1 and syringomyelia who underwent FMD with outer dura layer incision and C1 laminectomy. He experienced gait disturbance, hyperesthesia, and hyperhidrosis, which did not improve after the surgery. He experienced recurrence of the stenosis at the age of 16 years, for which he underwent resection of the regenerated C1 arch and duraplasty. His symptoms gradually resolved after the second surgery.The recurrence might have been caused by regeneration of the C1 laminae. Bone regeneration rarely necessitates reoperation. Frequent follow-up is important after decompression surgery for Chiari malformation in young patients.
尽管枕骨大孔减压术（FMD）对治疗 Chiari 畸形 I 型（CM1）有效，但在减压不足的情况下可能需要再次手术。我们遇到了一位患者，由于切除的 C1 椎板再生导致再狭窄，在 FMD 后需要再次手术。我们报告了一例 14 岁男孩患有症状性 CM1 和脊髓空洞症，接受了 FMD 手术，包括硬膜外切开和 C1 椎板切除术。他出现步态障碍、感觉过敏和多汗，手术后并未改善。他在 16 岁时出现狭窄复发，行再生 C1 弓切除和硬脑膜成形术。第二次手术后，他的症状逐渐缓解。复发可能是由于 C1 椎板的再生所致。骨再生很少需要再次手术。对于年轻患者的 Chiari 畸形减压手术后，需要频繁随访。
