Comparative study of alteration of local subarachnoid space before and after operation of Chiari malformation accompanied by syringomyelia
XU Zhong1,HE Xiaofei1,CHEN Huanran2,XU Minhui2
1. Department of Neurosurgery, Jiangsu Provincial Corps Hospital, Chinese People’s Armed Police Forces, Yangzhou 225003, China；2. Department of Neurosurgery, Daping Hospital, Third Military Medical University of Chinese PLA, Chongqing 400042, China
Abstract：Objective To observe the morphological changes of subarachnoid space(SS) at craniocervical junction(CCJ) in patients with type I Chiari malformation(CM I) accompanied by syringomyelia(SM) after the operation, and to study the pathogenesis of CM-SM. Methods The magnetic resonance images (MRI) in 34 CM I patients were reviewed. Twenty-seven patients underwent posterior fossa decompression with duraplasty (PFDD), and another 7 patients underwent posterior fossa decompression without duraplasty (PFD), and 23/34 were followed up by MRI. The extent of cerebellar tonsillar hernia (ECT), the α angle between clivus and the floor of the fourth ventricle, the volumes of the posterior cranial fossa(PCF), CCJ and SS on the sagital MRI were measured separately. Results Cerebellar tonsils elevated 10.07 mm,α angle increased by 1.95°, the PCF and CCJ volume increased by 11.29 ml and 6.29 ml respectively after procedure. The SS volume in CCJ region increased 14.44 ml (2.2 times that before procedure). These changes were of statistical difference compared with pre-procedure (P<0.05). The effective rate of PFDD (by a mean of 96.3%) was significant higher than that of PFD (by a mean of 71.4%)(P<0.05〉. Conclusions The narrowing of SS plays an important role in the pathogenesis of SM-CM. It is proved that PFDD for the treatment of CM-SM is preferred.
许 忠,何晓飞,陈焕燃,许民辉. Chiari畸形合并脊髓空洞症手术治疗前后颅颈部蛛网膜下腔形态学对比研究[J]. , 2012, 23(12): 1053-1055.
XU Zhong,HE Xiaofei,CHEN Huanran,XU Minhui. Comparative study of alteration of local subarachnoid space before and after operation of Chiari malformation accompanied by syringomyelia. , 2012, 23(12): 1053-1055.
2012, Vol. 23 
