Comparison Of The Efficacy Of Arnold-Chiari Ⅰ Malformation And Syringomyelia Surgery Way

PurposeBy analyzing 207 Arnold-Chiari I malformation with syringomyelia patients,clinical characteristics、perioperative treatment effect、the prevention and cure of complications、prognosis of comparative analysis,after operation during March 2000 to December 2015 in our hospital,discussing the therapeutic effects by treating Arnold-Chiari I malformation with syringomyelia patients in different surgical procedures,to improving the effects of operations、reduce complications、enhance the quality of life、reduce health care costs.MethodsThrough analyzing 207 Arnold-Chiari I malformation with syringomyelia patients were elected.Based on different surgical procedures in our hospital,they were divide into four sgroups;Group A incloud 124 patients:posterior cranial fossa decompression、atlas pillow fascia release and dural outer dissection.Group B incloud 49 patients:posterior cranial fossa decompression、epidural expand plasty and subarachnoid space exploration.Group C incloud 34 patients:posterior cranial fossa decompression,subarachnoid space exploration and cerebellar tonsil resection.We evaluated the effects of operations、prognosis、complications and conducted statistical analysis.ResultsThe number of patients with postoperative cerebrospinal fluid leakage and subcutaneous effusion in each group is:0、3、10(A、B、C);While 16、14、18 patients developed a fever in each group.0、2、6 patients happened to operative incision infection,in addition,0、1、1 patients occurred intracranial infection.At last,we found the difference of complications was statistically significant(P<0.05):group group C similar to D,and group A is superior to the latter.The number of patients with symptoms improving at discharge in each group is:95、38、27,while with no improvement but stable condition is:29、11、7,no patients condition worsens or died.We also found the difference of symptoms improving was no statistically significant(P<0.05).The effect of surgical procedure in group A、B、Care similar and is superior to group A.133outpatients were followed-up from 3 months to 3 ears(A:81;B30;C:22.).The were 68、26、19 patients who had symptoms improving in each group,and the number of patients review the MRI syringomyelia disappear or almost disappear is:31、10、8,while the narrowing lesions is:35、15、11,and the none changing or worsing is:15、5、3;The difference of syringomyelia period was no statistically significant(P<0.05).The effect of surgical procedure in group A、B、C、are similar.ConclusionsThree methods incloud posterior cranial fossa decompression with atlas pillow fascia release with dural outer dissection、posterior cranial fossa decompression with epidural expand plasty with subarachnoid space exploration、posterior cranial fossa decompression with subarachnoid space exploration with cerebellar tonsil resection treating Amold-Chiari I malformation with syringomyelia patients all has remarkable curative effect.And the former has less postoperative complications.