Comparing The Effects Between Two Different Operation Approaches In The Chiari-Ⅰ Malformation Patients

Objective: To evaluate the effects of the Chiari-I malformation patients with the two differentsurgical approaches.Methods：Collecting98patients of the Chiari Malformation type I in neurosurgery departmentfrom2000to2011by two different operation approaches. Group A:43patients who use theposterior cranial fossa bony decompression and putamen enlarge plasty surgery, and group B:55patients who use the posterior cranial fossa bony decompression and putamen enlarge plasty,arachnoid cavity of resportion exploration and hypohernia cerebellum tonsil excision surgery.Discuss the surgical effects and postoperative complications by the statistics analyze.Result: According to Tator’s evaluation criterions. When patients being discharged: there were29of the43patients had been improved,13patients got stable condition,1patient got worse,improvement rate is67%in group A; and in group B,49of the55patients had been improved,4patients got stable condition,2patients been worse, improving rate gets89%, and this result hasstatistical significance, P <0.05. Postoperative complications: there are13patients in group Aversus34patients in group B had the postoperative complications, the result has statisticalsignificance, P <0.05. The follow-up result, there are11of the27patients got better,7patientsgot stable conditions,9patients been worse, the rate of the effective is66.7%in group A; and33patients of the20patients had been improved,9patients been stable,4patients been worse,therate of the effective is87%in group B, the rate of the effective have the statistics significance,P <0.05.Conclusion：The surgical approach of the posterior cranial fossa bony decompression andputamen enlarge plasty, arachnoid cavity of resportion exploration and hypohernia cerebellumtonsil excision (cisterna magna reconstruction and dredging CSF circulation access) improvesymptoms quickly and have a good postoperative effects to treat the Chiari malformation type Ipatients. So this operation method is an ideal surgical approach, but has more postoperativecomplications.