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中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (11) : 937 -940. doi: 10.3877/cma.j.issn.1674-0785.2020.11.017

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综述

后颅窝减压术后脊髓空洞无好转再治疗的进展
苏新文1, 闫润民1,()   
  1. 1. 100048 北京,解放军总医院第四医学中心神经外科
  • 收稿日期:2020-04-07 出版日期:2020-11-15
  • 通信作者: 闫润民

Advances in research of reoperation after foramen magnum decompression for syringomyelia

Xiwen Su1, Runmin Yan1,()   

  1. 1. Department of Neurosurgery, PLA General Hospital Fourth Medical Center, Beijing 100048, China
  • Received:2020-04-07 Published:2020-11-15
  • Corresponding author: Runmin Yan
引用本文:

苏新文, 闫润民. 后颅窝减压术后脊髓空洞无好转再治疗的进展[J]. 中华临床医师杂志(电子版), 2020, 14(11): 937-940.

Xiwen Su, Runmin Yan. Advances in research of reoperation after foramen magnum decompression for syringomyelia[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(11): 937-940.

脊髓空洞约见于70%的Chiari畸形及10%的颅底凹陷。对于Chiari畸形合并脊髓空洞的手术治疗方案众多,主要有后颅窝减压术及空洞分流术。Chiari畸形合并脊髓空洞患者行不同方式后颅窝减压术,术后无效率国内外报道不一。目前对失败病例治疗有再行后颅窝减压术、脊髓空洞-蛛网膜下腔分流术、脊髓空洞-腹腔分流术、脊髓空洞-胸腔分流术、四脑室-颈髓蛛网膜下腔分流及特殊并发症的处理。每种术式的采用需具体病例具体分析,以达到缓解患者症状的目的。

Syringomyelia occurs in about 70% of cases with Chiari malformation and 10% of cases with basilar invagination. There are many surgical treatments for Chiari malformation with syringomyelia, such as posterior fossa decompression and cavitary shunt. Different methods of posterior fossa decompression have been performed in Chiari malformation with syringomyelia, with varying failed rates reported. At present, there are many reoperation procedures for failed cases, such as second foramen magnum decompression, syringo-subarachnoid shunt, syringo-abdominal shunt, syringo-thoracic shunt, fourth ventricle-cervical subarachnoid shunt, and surgical treatments for special complications. Each procedure should be selected based on the patient's condition to relieve the symptoms.

图1 后颅窝减压术后脊髓空洞无好转再治疗流程
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