Modified atlantooccipital decompression combined with occipitocervical internal fixation in treatment of Chiari malformation type I with syringomyelia and atlantoaxial dislocation
10.3760/cma.j.cn115354-20200103-00003
- VernacularTitle:改良寰枕减压术联合枕颈内固定术治疗Chiari畸形I型合并脊髓空洞症及寰枢椎脱位的疗效分析
- Author:
Xinjun LI
1
;
Yangyun HAN
;
Zhongshu SUN
;
Feng YE
;
Chen CHEN
;
Yingying LIU
;
Jiagang LIU
Author Information
1. 四川省德阳市人民医院神经外科，618000
- Keywords:
Aronld-Chiari type I malformation;
Syringomyelia;
Atlantooccipital decompression;
Occipitocervical fixation
- From:
Chinese Journal of Neuromedicine
2020;19(6):586-590
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of modified atlantooccipital decompression combined with occipitocervical internal fixation on Chiari type I malformation combined with syringomyelia and atlantoaxial dislocation.Methods:Twenty-five patients with Chiari I malformation combined with syringomyelia and atlantoaxial dislocation accepted by modified atlantooccipital decompression combined with occipitocervical internal fixation in our hospital from January 2011 to March 2019. The clinical data of these patients were retrospectively analyzed. The changes of peak velocity of cerebrospinal fluid in the dorsal part of the spinal cord, electrophysiological results, atlantodental interval (ADI) values, sizes of syringomyelia, and Chicago Chiari outcome scale (CCOS) scores before and after operation were compared.Results:The peak velocity of cerebrospinal fluid in the dorsal spinal cord after surgery ([3.25±0.47] cm/s) was statistically higher in these patients than that before surgery ([2.13±0.19] cm/s, P<0.05). As compared with the preoperative results, ADI values, sizes of syringomyelia, and proportion of patients with abnormal electrophysiological monitoring at 6 months after surgery were significantly decreased, and CCOS scores at 6 months after surgery were significantly increased ( P<0.05). There were no new nerve function damage, infection, cerebrospinal fluid leakage, paralysis, respiratory failure or death. Conclusions:Modified atlantooccipital decompression combined with occipitocervical internal fixation plays effective role in atlantooccipital decompression and atlantoaxial anatomical reduction in patients with Chiari malformation type I combined with syringomyelia and atlantoaxial dislocation. The remission rate of syringomyelia is high, the symptoms and signs improve obviously, and the postoperative complications are less.
