CAJ | 학술논문

目的研究以脊柱侧凸为首发症状的Chiari畸形的临床特征和治疗策略.方法收集南京鼓楼陕院住院治疗的Chiari畸形患者60例,35例以脊柱侧凸为首发症状;25例末合并脊柱侧凸作为对照组,病例对照研究.结果 35例Chiari畸形合并脊柱侧凸患者,年龄3～33岁(平均13.75岁),97%合并脊髓空洞,不具有典型的Chiari畸形的临床症状和体征,以腹壁反射异常多见.两组之间手术方式和手术并发症无统计学意义.结论 Chiari畸形以脊柱侧凸为首发症状,多合并脊髓空洞,发病年龄轻,其临床症状和神经损害体征不明显,治疗策略上主张早期进行枕颈部枕骨大孔区减压和硬脑膜重建成形手术.
목적 연구이척주측철위수발증상적Chiari기형적림상특정화치료책략.방법 수집남경고루협원주원치료적Chiari기형환자60례,35례이척주측철위수발증상;25례말합병척주측철작위대조조,병례대조연구.결과 35례Chiari기형합병척주측철환자,년령3～33세(평균13.75세),97%합병척수공동,불구유전형적Chiari기형적림상증상화체정,이복벽반사이상다견.량조지간수술방식화수술병발증무통계학의의.결론 Chiari기형이척주측철위수발증상,다합병척수공동,발병년령경,기림상증상화신경손해체정불명현,치료책략상주장조기진행침경부침골대공구감압화경뇌막중건성형수술.
Objective To study the clinical manifestation and intervention strategy for Chiari malformation associated with seoliosis as the first symptom.Methods 60 patients with Chiari malformation were included in this control study.Among which 35 patients were Confirmed to be Chiari malformation associmed with scoliosis as the first symptom.These 35 patients were included in test group and the other 25 patients were included in control group.Results 35 patients in test group were younger(3～33 yrs old,average 13.75 yrs).The abnormal neurological manifestation of typical Chiari malfi,rmation was slight in test group.Most of these patients in test group had syringomyelia(97%)and ahnormal upper abdominal reflex.There was no diflhrence between the two groups in surgical intervention and postoperative complication.Conclusions In order to decrease the risk of neurological complication,foramen magnum decompression (include C.posterior arch)is necessary before instrumentation and correction of scoliosis in Chiari malformation patients with syringomyelia and scoliosis as the first symptom.