论文部分内容阅读
目的 探讨Chiari-Ⅰ畸形合并脊髓空洞症的发病机制,以寻求更为可行的治疗方法。方法 对156例经MRI证实的Chiari-Ⅰ畸形/脊髓空洞症(CML/SM)的手术治疗进行回顾性研究,分析脊髓空洞形成与延颈髓交界处下行血管压迫的关系。结果术中见所有患者小脑扁桃体对延髓及颈髓上段的后外份均有明显的挤压及不同程度的粘连,131例(84％)可见局部的蛛网膜增厚并对下行的脊髓后动脉形成不同程度的牵扯或压迫。结论 颈髓局部血供的进行性下降所造成的相应区域的微循环障碍及营养不良,可能导致局部神经细胞的变性、坏死、液化,最终形成空洞。手术治疗强调对这些血管压迫的解除,改善病变区域的血液循环。
Objective To investigate the pathogenesis of Chiari-Ⅰ malformation associated with syringomyelia in order to seek more feasible treatment. Methods The surgical treatment of 156 cases of Chiari-Ⅰ deformity / syringomyelia (CML / SM) proved by MRI was retrospectively analyzed. The relationship between the formation of syringomyelia and the descending vascular compression at the junction of the cervical spinal cord was analyzed. Results All the patients had cerebellar tonsillar tonsils in the medulla oblongata and cervical upper exocaval after a significant extrusion and different degrees of adhesion, 131 cases (84%) showed local arachnoid thickening and the descending posterior spinal artery To form a different degree of involvement or oppression. Conclusion The microcirculation and malnutrition in the corresponding regions caused by the progressive decrease of blood supply to the cervical spinal cord may lead to the degeneration, necrosis and liquefaction of local nerve cells, and finally the formation of voids. Surgical treatment emphasizes the lifting of these vascular compression and improves blood circulation in diseased areas.