Arnold-Chiari 奇形に合併した脊髄空洞症に対する空洞-くも膜下腔交通術の経験

抄録

Clinical outcomes and magnetic resonance imaging (MRI) findings were evaluated for patients with syringomyelia associated with Arnold-Chiari malformation type I after syrinx-subarachnoid shunting. Subjects included four patients, 1 male and 3 females, with a mean age at surgery of 42.5 years and a mean follow up period of 1.9 years.
Following laminoplasty or fenestration, myelotomy was performed at the dorsal root entry zone (DREZ) of the cord. The cavity was drained by insertion of a shunt tube (diameter 1.2-1.4mm) at the DREZ into the cephalic side for a distance of 2-3cm. Neurological deterioration improved in 3 of the 4 patients at the final observation. MRI disclosed a remarkable deflation of the syrinx in 3 patients at follow up. We did not encounter major complications such as neurological deficits.
The results of the current study suggest that syrinx-subarachnoid shunting is useful and safe for the treatment of syringomyelia associated with Arnold-Chiari malformation type I.