Soleman Jehuda, Roth Jonathan, Constantini Shlomi
Department of Pediatric Neurosurgery, Tel Aviv Medical Center, Tel Aviv, Israel.
Department of Pediatric Neurosurgery, Children's University Hospital of Basel, Basel, Switzerland.
Adv Tech Stand Neurosurg. 2023;48:73-107. doi: 10.1007/978-3-031-36785-4_4.
Chiari type 1 malformation (CIM) is defined as tonsillar ectopia of >5 mm, while syringomyelia (SM) is defined as a cerebrospinal fluid (CSF)-filled cavity larger than 3 mm dissecting the spinal cord. Over the last decades, our understanding of these pathologies has grown; however, many controversies still exist almost in every aspect of CIM and SM, including etiology, indication for treatment, timing of treatment, surgical technique, follow-up regime, and outcome. This chapter provides a comprehensive overview on different aspects of CIM and SM and on the still existing controversies, based on the evidence presently available. Future directions for clinical research concerning CIM and SM treatment and outcome are elaborated and discussed as well.
Chiari 1型畸形(CIM)定义为扁桃体下疝超过5毫米,而脊髓空洞症(SM)定义为脊髓内大于3毫米的充满脑脊液(CSF)的空洞。在过去几十年里,我们对这些疾病的认识有所增加;然而,在CIM和SM的几乎每个方面仍存在许多争议,包括病因、治疗指征、治疗时机、手术技术、随访方案和治疗结果。本章基于目前可得的证据,对CIM和SM的不同方面以及仍然存在的争议进行全面概述。还阐述并讨论了关于CIM和SM治疗及结果的临床研究的未来方向。