Effect Comparison Of Three Different Surgical Treatments For Arnold-Chiari Malformation Type â… 

Objective:To compare the therapeutic effect of simpleposterior cranial fossa decompression、posterior cranial fossa decompression+ dural expansion repair and posterior cranial fossa decompression+ dural expansion repair+ cerebellar tonsillar processing.Methods:Retrospective analysis of 47 cases of Arnold-Chiari malformationtype I, admitted in Neurosurgery of The First Affiliated Hospital of Guangxi Medical University, from March 2005 to March 2015,divided into three groups:A group,13 cases of patients were treated with simple posterior cranial fossa decompression, B group,15 cases underwent posterior cranial fossa decompression+ dural expansion repair, C group,19 cases of patients were treated with posterior cranial fossa decompression+ dural expansion repair+ cerebellar tonsillar processing, recorded their related data:age, gender, onset, the image science data and results, comparative analysis of the safety of operation, complication rate and short - and long-term effect.Results:There was no death in the three groups, the simple posterior cranial fossa decompression group (A group),after discharge,10 cases were improved,2 cases were stable,1 cases were worse,4 cases had complications after surgery.The posterior cranial fossa decompression+dural expansion repair group (B group),13 cases were improved,2 cases were stable,3 cases had complications after surgery.The posterior cranial fossa decompression+dural expansion repair+ cerebellar tonsillar processing group (C group),17 cases were improved,1 cases were stable,1 cases were worse,6 cases had complications after surgery. By chi square test, Fisher’s exact probability test, there were no significant differences in the proportion of postoperative complications between the three groups. There was no significant difference in the short-term effect between the three groups, but the long-term effect was statistically significant, The long-term effects of B group and C group were better than those of A group.Conclusion:Three kinds of operative methods for treatment Arnold-Chiari I malformation is safe and effective, there was no significant difference in the incidence of postoperative complications,and there was no significant difference in the effects between the three groups in the short-term, but the long-term effect was statistically significant. The posterior cranial fossa decompression+ dural expansion repair and the posterior cranial fossa decompression+ dural expansion repair+ cerebellar tonsillar processing was superior to the simple posterior cranial fossa decompression...