Iwasaki Y, Hida K, Koyanagi I, Kuroda S, Abe H
Rinsho Shinkeigaku. 1995 Dec;35(12):1409-11.
Two major surgical procedures, i.e., foramen magnum decompression (FMD) and syringo-subarachnoid shunt (S-S shunt) have been performed as the treatment for syringomyelia with Chiari malformation in our department. FMD was done principally in patients with symptoms due to Chiari malformation and for small size or localized syrinx, and S-S shunt was applied to patients with main symptoms due to syringomyelia, especially with local pain and for large syrinx in size. Eighty patients of syringomyelia with Chiari malformation were surgically treated. FMD was performed in 38 patients, and S-S shunt in 39 patients as the first operation. FMD were done with craniectomy of posterior fossa, C1 laminectomy and resection of epidural band, but without opening dura, and S-S shunt were done with hemipartial laminectomy and DREZtomy. The clinical outcome was evaluated, comparing the two major surgical procedures. Satisfactory neurological improvement was obtained in the two groups, but S-S shunt group took better improvement than FMD group. These results suggest that both procedures are effective, but should be selected by preoperative clinical and radiological findings.
在我们科室，已经开展了两种主要的外科手术，即枕大孔减压术（FMD）和脊髓空洞-蛛网膜下腔分流术（S-S分流术），用于治疗合并Chiari畸形的脊髓空洞症。FMD主要针对因Chiari畸形出现症状且脊髓空洞较小或局限的患者进行，而S-S分流术则应用于主要因脊髓空洞症出现症状的患者，尤其是伴有局部疼痛且脊髓空洞较大的患者。80例合并Chiari畸形的脊髓空洞症患者接受了手术治疗。38例患者接受了FMD作为首次手术，39例患者接受了S-S分流术作为首次手术。FMD手术包括后颅窝颅骨切除术、C1椎板切除术和硬膜外束带切除术，但不打开硬脑膜，而S-S分流术则进行半椎板切除术和脊髓后角切开术。对这两种主要外科手术的临床结果进行了评估和比较。两组患者均获得了满意的神经功能改善，但S-S分流术组的改善情况优于FMD组。这些结果表明，两种手术方法均有效，但应根据术前的临床和影像学检查结果进行选择。
