科研之友
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摘要
Objective: Although several surgical techniques for Chiari Malformation Type 1 (CM1) have been described, the best surgical treatment is still controversial. The aim of this study was to describe a simplified surgical technique for the treatment of patients with CM1. %26lt;br%26gt;Methods: A total of 25 CM1 patients, admitted to our tertiary center constituted the study group. All cases underwent suboccipital decompression by removal of posterior lip of foramen magnum using Kerrison rongeurs after the resection of C1 posterior arch. The craniectomy was completed superiorly without making any burr holes for avoiding complication in all patients. Neurological examination was performed preoperatively and 1 day, and 2, 6, and 12 months after surgery. Craniocervical and cervical spinal cord MRIs were examined and recorded for the presence of tonsillar descents and syringomyelia preoperatively. A follow up MRI was performed two months after surgery. %26lt;br%26gt;Results: The mean follow-up period was 65.02 +/- 16.94 (range, 46 to 94) months. Most common symptoms and findings were occipital and neck pain radiating to the upper extremity (n= 23, 92%), followed by numbness (n= 22, 88%), sensory disturbance of the upper extremity (n= 15, 60%), and vertigo (n= 13, 52%). No major complications were observed in the postoperative period. Clinical progression was halted in all patients; 18 (72%) patients recovered completely and six (24%) patients reported partial recovery. Syringomyelic cavity persisted radiologically in five (20%) patients, decreased in size in 15 (60%) patients, and regressed completely in the remaining five (20%) patients. %26lt;br%26gt;Conclusion: Foramen magnum decompression without burr hole is a safe and easy to perform technique. This technique can be used almost in all cases instead of the commonly used suboccipital craniectomy technique with burr hole.
- 出版日期2014
