解放军医学杂志2011，Vol.36Issue(2)：119-121,3.
Chiari畸形合并颅底凹陷的外科手术治疗
Surgical treatment of Chiari malformation complicated with basilar impression
马原 1贺伟旗 1程林 1卢敏 1顾建文 1匡永勤 1夏勋 1杨立斌 1张俊海 1程敬民 1杨涛 1黄海东1
作者信息
- 1. 610083,成都,成都军区总医院神经外科
- 折叠
摘要
Abstract
Objective To evaluate the therapeutic effect of small craniotomic posterior fossa decompression combined with occipitalcervical bone graft fusion and internal fixation on Chiari malformation complicated with basilar impression. Methods The clinical data of 16 cases (7 males and 9 females, aged 17 to 65 years, mean 36. 4) of Chiari malformation complicated with basilar impression from 2006 to 2010 were retrospectively analyzed. The diagnoses for all the patients were confirmed by radiology. Small craniotomic posterior fossa decompression was performed in all patients, cerebellar tonsils were resected, and then one-stage occipital-cervical bone graft fusion using autogenous iliac bone and internal wiring fixation were performed. Neck support was used for 3 months after surgery. Results Symptoms were significantly improved in all cases after surgical operation. No patient died or infected. Cerebrospinal fluid leakage was found at draining site in one case. Transient pain of scapular and chest was found in one case and disappeared spontaneously. A 6-months follow-up showed that 6 patients were cured, 9 improved and 1 unchanged according to Symon and Lavender standard. Postoperative MRI showed the reconstructed cisterna magna was clear in all patients, no cerebellar ptosis was found, and the occipital-cervical graft bone was fused.Conclusion In patients with Chiari malformation complicated with basilar impression, small craniotomic posterior fossa decompression combined with one-stage occipital-cervical bone graft fusion and internal wiring fixation has a clear and definite effect, it can increase the volume of posterior fossa and alleviate the ventral brain stem compression simultaneously, and reconstruct the stability of cranio-cervieal junction.关键词
Arnold-Chiari畸形/减压术,外科/神经外科手术Key words
Arnold-Chiari malformation/ decompression/ surgical/ neurosurgical procedures分类
医药卫生引用本文复制引用
马原,贺伟旗,程林,卢敏,顾建文,匡永勤,夏勋,杨立斌,张俊海,程敬民,杨涛,黄海东..Chiari畸形合并颅底凹陷的外科手术治疗[J].解放军医学杂志,2011,36(2):119-121,3.
