CAJ | 학술논문

目的探讨颅底凹陷症发病机制及其对手术方式选择的意义.方法 2009年7月至2013年5月收治颅底凹陷症患者9例,均接受手术治疗,其中男5例,女4例;年龄19 ～51岁,平均37岁.测量Chamberlain线值、McRae线值、Wackenheim clival线值、寰齿前间距(AID)、Klaus height指数及延脊髓角度.9例均为原发性颅底凹陷症,行经口咽寰枢椎松解复位+后路枕骨大孔减压术+枕颈植骨固定融合术;术后随访3个月～3年.结果除1例临床症状无改善外,其余8例症状明显改善,经MRI复查对比,所有病例后颅窝容积均有扩大,对延髓腹侧受压成角度的患者受压明显改善,脊髓空洞的患者空洞明显缩小.结论经口咽寰枢椎松解复位+后路枕骨大孔减压术+枕颈植骨固定融合术,手术效果明显,安全性高,值得推广.
목적 탐토로저요함증발병궤제급기대수술방식선택적의의.방법 2009년7월지2013년5월수치로저요함증환자9례,균접수수술치료,기중남5례,녀4례;년령19 ～51세,평균37세.측량Chamberlain선치、McRae선치、Wackenheim clival선치、환치전간거(AID)、Klaus height지수급연척수각도.9례균위원발성로저요함증,행경구인환추추송해복위+후로침골대공감압술+침경식골고정융합술;술후수방3개월～3년.결과 제1례림상증상무개선외,기여8례증상명현개선,경MRI복사대비,소유병례후로와용적균유확대,대연수복측수압성각도적환자수압명현개선,척수공동적환자공동명현축소.결론 경구인환추추송해복위+후로침골대공감압술+침경식골고정융합술,수술효과명현,안전성고,치득추엄.
Objective To explore a classification system of basilar invagination based on pathogenesis and to investigate its clinical significance.Methods From July 2009 to May 2013,9 patients with basilar invagination were treated at our department by surgery,5 males and 4 females with a mean age of 37 years(ranged 19-51 years).There are three elements for diagnosis basilar invagination in Magnetic Resonance Imaging (MRI):the first,Boogard angle more than 145 ; the second,the top edge of odontoid higher than Chamberlain's line more than 5 mm; The third,the top of odontoid distance from the line between the tuberculum sellae and occipital protuberance less than 30 mm.In accordance with one of the above three elements can be regarded as basilar invagination.All of the 9 case were regarded as congenital basilar invagination and treated with Transoral approach ventral decompression and posterior occipitocervical fusion internal fixation.Postoperative follow-up is of 3 months to 3 years.Results Besides one case's symptoms were worse than those of this case before the operation.Another 8 cases' clinical symptoms showed an improvement which made these cases better than they were before the operation.It can be proved by MRI.Conclusions Transoral approach ventral decompression,posterior occipitocervical fusion and internal fixation for Basilar Invagination is safe and for basilar invagination.