Comparison of the efficacy of different decompressions treatment combined with posterior cervical fusion and internal fixation treatment on Chiari I malformation associated with syringomyelia and atlantoaxial instability
10.3760/cma.j.issn.1008-6706.2019.13.014
- VernacularTitle: 不同减压术式联合颈后路融合内固定术治疗ChiariⅠ型畸形合并脊髓空洞症、寰枢关节不稳的疗效比较
- Author:
Huailong LI
1
;
Libin GUO
;
Jianrong LIANG
Author Information
1. Department of Neurosurgery, Linfen Hospital Affiliated to Shanxi Medical University(the Seventh Clinical Medical College), Linfen People's Hospital, Linfen, Shanxi 041000, China
- Publication Type:Journal Article
- Keywords:
Arnold-Chiari malformation;
Syringomyelia;
Decompression, surgical;
Decompression of posterior fossa of small bone window;
Cerebellar tonsillectomy;
Posterior cervical fusion and internal fixation;
Atlantoaxial instability;
Comparative study
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(13):1591-1595
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy of different decompressions treatment combined with posterior cervical fusion and internal fixation treatment on Chiari I malformation associated with syringomyelia and atlantoaxial instability.
Methods:From January 2016 to October 2017, 36 cases of Chiari I malformation associated with syringomyelia and atlantoaxial instability in Linfen People's Hospital were selected in the research.The patients were divided into two groups according to random number table method, with 18 cases in each group.The observation group was given decompression of posterior fossa of small bone window + cerebellar tonsillectomy + posterior cervical fusion and internal fixation treatment.The control group was given traditional decompression of posterior fossa + posterior cervical fusion and internal fixation treatment.The efficacy, complications occurred within 1 year after operation, JOA score and spinal cord cavity size at different time points before and after operation of the two groups were compared.
Results:The total effective rate of the observation group [94.44%(17/18)] was slightly higher than that of the control group [88.89%(16/18)] (χ2=1.957, P>0.05). The total effective rate of the observation group at 1 year after operation was 88.89%(16/18), which was significantly higher than that of the control group [72.22%(13/18)] (χ2=3.498, P<0.05). The incidence rate of complications of the observation group at 1 year after operation was 11.11%(2/18), which was significantly lower than that of the control group [38.89%(7/18)](χ2=11.685, P<0.05). The JOA scores at discharge[(15.97±1.25)point] and 1 year after operation[(15.53±1.19)point] of the observation group were significantly higher than those of the control group[(14.21±1.18)point, (14.06±1.15)point](t=3.815, 3.706, all P<0.05). The spinal cord cavity size at discharge [(2.13±0.64)mm] and 1 year after operation[(2.28±0.69)mm] of the observation group were significantly higher than those of the control group [(3.41±0.76)mm, (3.45±0.78)mm](t=5.743, 5.511, all P<0.05).
Conclusion:The long-term efficacy of decompression of posterior fossa of small bone window + cerebellar tonsillectomy + posterior cervical fusion and internal fixation treatment on Chiari I malformation associated with syringomyelia and atlantoaxial instability is remarkable, the recovery of spinal cord function and syringomyelia is well and the postoperative complications incidence is relatively low, which is worthy of popularization and application.
