Neurosurgical Treatment Of Arnold-Chiari Malformation

Objective To explore the operational method and curative effecton Arnold-Chiari malformation and seek for the more effectivesurgical treatment, to provide some references for future clinical woks. Methods 143 patients with Arnold-Chiari malformation wereunderwent different operational methods in our hospital from January1999 to December 2005, within them 86 patients were successfullyfollowed up. To study and research the clinical therapeutic efficacy ofdifferent operating technics by patient prognosis and seek for the moreeffective surgical treatment. Results All patients with surgical treatment had different degreeof amelioration with self-sensation symptom than preoperative duringthe period of hospitalization except one patient dead. Within the 86patients with follow-up, the effective ratio of operating type A is66.7%, the total effective ratio of operating type B and C is 88.1%,they were significant difference by X2 test(P<0.05), which indicatethat the prognosis of open-dural is surpass close-dural. Thepostoperative complications of expansile reconstruction of posteriorfossa is lower than open wide, they were significant difference by X2test(P<0.05). 15 cases suffered from syringomyelia rechecked MRIamong follow-up visits, 12 cases had different degree improvement inimage signs, they showed that cavity/spinal width or segment ofcavity decreased. 2 cases were not obviously change, one case wasaggravate.Conclusion The posterior fossa decompression with expansilereconstruction is an effective technique in the treatments ofArnold-Chiari malformation. It not only have better therapeuticefficacy but also reduce postoperative complications. It wasrecommended in future clinical works.