Analysis Of The Chiari Malformation TypeⅠand Surgical Efficacy Of The Treatment Of Syringomyelia

Objective：Chiari malformation Clinical generally refers to the typeⅠ, and it includes fourbrain malformation Chiari malformation typeⅠ, also known as primary microcephaly shift oradult Chiari malformation (mostly in the 10-30 years of age-related symptoms and signs oftreatment and diagnosis,), the disease is a common disease caused by a variety of factors, 30%-70% of patients with established disease syringomyelia symptoms and signs of Chiarimalformation typeⅠand syringomyelia high level of disability, early sensory disturbances,and gradually developed hand interosseous muscle and thenar muscle atrophy, autonomicdysfunction, weight Xia Keshi joints, difficulty walking performance, severe cases, loss of laborand life skills. magnetic resonance imaging (Magnetic Resonance imaging) for the preoperativediagnosis of tonsillar hernia greatly assist clinicians in practice: Chiari malformationⅰtypeand spinal cord with syringomyelia, the neurological surgeon alone their own clinical experienceto take from that the best surgical approach, but someefficacy of patients are not satisfied.Therefore, choose the best surgical approach, to improve the prognosis has become an urgentneed to address the current problems.This article is intended to summary of Chiari malformation typeⅠand empty the patient’ssurgical treatment and efficacy of spinal cord, to find the best surgical approach, and want to beable to play a guiding role in the clinical work.Methods：Neurosurgery in March 2010 to 2011 in December, the First Hospital of ShanxiMedical Surgical treatment of 61 cases of patients with Chiari malformation type I mergersyringomyelia. This paper summarizes the analysis of 41 cases were followed up, and theirclinical data, imaging data, surgical approach, surgical indications, complications and prognosiswas analyzed. Patients were using technique A: simple atlanto occipital decompression ringpillow fascia release surgery (do not cut the dura mater); procedure B: before decompressionwith bone, "Y" cut dura loosen adhesions, arachnoid, from the tendon line of the body fascia orartificial meningeal dural sac to expand angioplasty; surgical C: B technique based on the uplinksyringomyelia shunt. For statistical analysis, according to whether or not patients’ symptoms andsigns of postoperative relief is divided into: improved, stable, deteriorating. Whether to cut thedura mater to the surgery, the surgical approach is divided into two groups: dural incision group,the dural incision group. Surgery type A is not cut the dura mater group, surgical / incision of thedura mater group. Dural incision group and dural incision postoperative effects of the group ofpatients were compared using the Wilcoxon rank sum test for statistical analysis, differenceswere significant (P <0.05). Dural incision group and dural incision group of postoperative complications were compared using theχ~2 test for statistical analysis, differences weresignificant (P <0.05).Results：Two groups of postoperative curative effect is (see table 3), the SPSS17.0 packageanalysis, the rank and inspection (P > 0.05), Z = 0.089, P = 0.921﹥0.05, no statisticalsignificance, two groups of curative effect is not statistically significant differences. Thepostoperative complications two groups of comparisons (see table 4), the SPSS17.0 packageanalysis, the chi-square test (P﹤0.05), the chi-square = 11.334, P = 0.001﹤0.05, astatistically significant, there is a significant difference of statistical significance.Conclusion：Cut the dura mater can not cut the dura mater of two sets of surgical approach tothe treatment of Chiari malformation type I merger syringomyelia, and no significant differencein postoperative effects; simple atlanto occipital decompression ring pillow fascia loosethesolution technique (do not cut the dura mater) can significantly reduce the occurrence of relatedcomplications.