Analysis of the effect of combined surgical treatment atlantooccipital malformation with syringomyelia

doi:10.3877/cma.j.issn.2095-9141.2024.06.002

Abstract

Abstract:

Objective

To analyze the clinical effect of cervical spine fixation and posterior fossa decompression combined with syringomyelo-subarachnoid drainage in the treatment of atlantooccipital malformation with syringomyelia （SY）.

Methods

A retrospective collection was conducted on 93 patients with atlantoaxial malformation combined with SY syndrome who underwent cervical spine fixation and posterior fossa decompression combined with syringomyelo - subarachnoid drainage in Neurosurgery Department of the 920^th Hospital of PLA Joint Logistics Support Force from January 2017 to May 2024.The clinical symptoms，changes in SY diameter and volume，and imaging data before and after surgery were compared and analyzed.

Results

After the Combined surgical treatment， the patient's symptoms such as headache， dizziness， neck and shoulder pain， numbness， limb immobility， difficulty in moving limbs or unsteady walking， posterior cranial nerve disorders， decreased muscle strength in the limbs， and sensory impairment were significantly relieved， while muscle atrophy improved less. The maximum anterior posterior diameter of the SY， the anterior posterior diameter of the spinal cord in the same plane，the ratio of the cavity to the spinal cord，the length of the cavity，and the volume of the cavity in postoperative patients were significantly reduced compared with preoperative values， and the differences were statistically significant （P＜0.05）. Postoperative MRI showed significant improvement in cavity volume in 82 cases （88.2%）， improvement in 10 cases （10.8%）， and no improvement in 1 case（1.1%）.

Conclusion

Cervical spine fixation and posterior fossa decompression combined with syringomyelo-subarachnoid drainage is effective and safe in treating atlantoaxial malformation with SY.

Key words: Atlas occipital deformity, Syringomyelia, Syringomyelo-subarachnoid shunt

Zhiqiang Dai, Wei Luo, Jiaxin Xie, Yuyang Liu, Jie Li, Xin Zhang, Xunding Deng, Ning Cao, Yaping Feng. Analysis of the effect of combined surgical treatment atlantooccipital malformation with syringomyelia[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2024, 10(06): 325-329.

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References 16

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时间	脊髓空洞最大前后直径（mm）	同平面脊髓前后直径（mm）	空洞脊髓比	空洞长度（mm）	空洞体积（mL）
术前	5.60（4.70，6.60）	9.00（8.10，10.15）	0.60（0.53，0.69）	180.00（120.00，252.50）	3.69（2.14，6.23）
术后	2.30（1.85，3.15）	7.70（7.00，8.70）	0.31（0.23，0.43）	120.00（85.00，220.00）	0.59（0.27，1.15）
Z值	8.375	8.278	8.232	7.835	8.374
P值	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

时间	脊髓空洞最大前后直径（mm）	同平面脊髓前后直径（mm）	空洞脊髓比	空洞长度（mm）	空洞体积（mL）
术前	5.60（4.70，6.60）	9.00（8.10，10.15）	0.60（0.53，0.69）	180.00（120.00，252.50）	3.69（2.14，6.23）
术后	2.30（1.85，3.15）	7.70（7.00，8.70）	0.31（0.23，0.43）	120.00（85.00，220.00）	0.59（0.27，1.15）
Z值	8.375	8.278	8.232	7.835	8.374
P值	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

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