Isu T, Sasaki H, Takamura H, Kobayashi N
Department of Neurosurgery, Kushiro Rousai Hospital, Japan.
Neurosurgery. 1993 Nov;33(5):845-9; discussion 849-50.
The surgical results of foramen magnum decompression in seven patients with syringomyelia associated with Chiari I malformations are reported. The patients were two men and five women, ranging in age from 23 to 54 years (mean, 30 yr). A bony foramen magnum decompression combined with the removal of the outer layer of the dura mater was performed in seven patients. In an average postoperative follow-up period of 2 years (range, 1-3 yr), neurological symptoms and signs improved in six of seven patients and were unchanged in one patient. Postoperative magnetic resonance imaging scans taken a few weeks after surgery showed a decrease in the size of the syrinx or a disappearance of the syrinx in five of seven patients; a few months were required for a similar reduction in the remaining two patients. In all seven patients, the decompression of the foramen magnum proved to be sufficient, as disclosed by postoperative magnetic resonance imaging. Foramen magnum decompression by our surgical technique is advantageous because all the procedures are extradural and there are, therefore, fewer postoperative complications than the foramen magnum decompression techniques previously reported. Foramen magnum decompression by the authors' surgical technique is effective as the initial surgical treatment for syringomyelia associated with Chiari I malformations.
报告了7例合并Chiari I畸形的脊髓空洞症患者行枕骨大孔减压术的手术结果。患者中男性2例，女性5例，年龄在23至54岁之间（平均30岁）。7例患者均行枕骨大孔骨性减压并切除硬脑膜外层。术后平均随访2年（范围1至3年），7例患者中有6例神经症状和体征改善，1例无变化。术后数周的磁共振成像扫描显示，7例患者中有5例脊髓空洞大小减小或空洞消失；其余2例患者在数月后出现类似程度的减小。术后磁共振成像显示，所有7例患者的枕骨大孔减压均充分。采用我们的手术技术进行枕骨大孔减压具有优势，因为所有操作均在硬膜外进行，因此与先前报道的枕骨大孔减压技术相比，术后并发症更少。作者的手术技术进行枕骨大孔减压作为合并Chiari I畸形的脊髓空洞症的初始手术治疗是有效的。
