Arnold ChiariⅠ畸形合并脊髓空洞的手术分析  

Clinical study of surgical treatment for Arnold Chiari malformation type Ⅰ with syringomyelia

作　　者：苏亦明[1] 陈飞[2] 孙亚邓[1] 

机构地区：[1]广东医学院第三附属医院神经外科,茂名525011 [2]江苏南通瑞慈医院神经外科,南通226010

出　　处：《中国实用神经疾病杂志》2007年第4期20-22,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的 探讨Arnold Chiari Ⅰ畸形（Arnold Chiari Malformation type Ⅰ,ACM）合并脊髓空洞（Syringomyelia,SM）的外科治疗方法.方法 对2000～2006年36例ACM合并SM的患者采用后颅窝减压、成形术,并根据不同的临床特点予以空洞切开引流、下疝小脑扁桃体切除、颈枕交界区粘连分离以及脊髓中央管口松解术.结果 术后随访1年以上,症状明显缓解28例,稳定无变化7例,1例疼痛加重并出现对侧上肢麻木;MRI检查示2例脊髓空洞消失,26例空洞明显缩小,8例空洞无明显变化.结论 缓解颅颈交界区的压迫和疏通脑脊液循环是手术成功的根本.Objective To explore the effective surgical treatment of Arnold chiari malformation type I （ACM） with syringomyelia（SM）. Methods 36 patients of ACM with SM were surgically treated form 2000 to 2006. According to the clinical features, all patients were treated with cavernotomy and drainage, tonsillectomy, lysis of occipitocervical junction and incision of central canal opening depend on basis of posterior fossa decompression and duraplasty. Results The follow--up period was more than 1 year, 28 cases in 36 clinic symptom had been improved obviously after operation, 7 eases clinic symptom were stable, 1 ease symptom had been increased; 2 cases syringomyelia had been disappeared ,and 34 eases were reduced apparently. Conclusion Restoring cerebrospinal fluid circulation and relieving the compression of occipitocervical junction are the key re treat ACM with SM.

关 键 词：ARNOLD Chiari畸形 脊髓空洞 后颅窝减压 后颅窝成形 小脑扁桃体 脊髓中央管口 

分 类 号：R742.82[医药卫生—神经病学与精神病学] R744.4[医药卫生—临床医学]