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[Modified reconstruction of the cistern magna for treatment of syringomyelia with Chiari malformation: clinical analysis of 35 cases].
Nan Fang Yi Ke Da Xue Xue Bao. 2009 Feb; 29(2):284-8.NF

Abstract

OBJECTIVE

To explore the surgical approaches, microsurgical techniques and therapeutic effect of modified cistern magna reconstruction for treating of syringomyelia with Chiari malformations.

METHODS

The clinical data of 35 patients with syringomyelia complicated by Chiari malformations were retrospectively reviewed, and the patients' chief complaints, presenting symptoms, neurological and radiographic findings, surgical approaches, outcomes, and complications were analyzed.

RESULTS

The radiographs revealed type I Chiari in 18 and type II Chiari malformations in these patients. Surgical treatment resulted in symptomatic improvements in 29 patients, and 6 patients showed no obvious changes in the symptoms after the surgery; 3 patients received subarachnoid shunting for syringomyelia. During the follow-up for a mean of 2 years, 32 patients showed obvious clinical improvement, and magnetic resonance imaging demonstrated complete spontaneous resolution of syringobulbia in 25 patients.

CONCLUSION

Modified cistern magna reconstruction relieves brainstem compression and restores the pulsatile flow of the cerebrospinal fluid at the cervicomedullary junction. Cerebellar tonsil reduction is performed chiefly by electric coagulation and cauterization combined with subpial resection, and the integrity of the pia mater should be maintained as much as possible to avoid potential adhesion and recurrence. The median foramens and Luschka of the fourth ventricle have to be opened to recover normal CSF circulation. Arachnoidal suspension and placement of a patulous dural graft are also important. Modified reconstruction of the cistern magna can be a good option for treatment of syringomyelia complicated by Chiari malformations.

Authors+Show Affiliations

Huiqiao Department, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. penglin@fimmu.comNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

19246301

Citation

Peng, Lin, et al. "[Modified Reconstruction of the Cistern Magna for Treatment of Syringomyelia With Chiari Malformation: Clinical Analysis of 35 Cases]." Nan Fang Yi Ke Da Xue Xue Bao = Journal of Southern Medical University, vol. 29, no. 2, 2009, pp. 284-8.
Peng L, Qi ST, Zhu WL. [Modified reconstruction of the cistern magna for treatment of syringomyelia with Chiari malformation: clinical analysis of 35 cases]. Nan Fang Yi Ke Da Xue Xue Bao. 2009;29(2):284-8.
Peng, L., Qi, S. T., & Zhu, W. L. (2009). [Modified reconstruction of the cistern magna for treatment of syringomyelia with Chiari malformation: clinical analysis of 35 cases]. Nan Fang Yi Ke Da Xue Xue Bao = Journal of Southern Medical University, 29(2), 284-8.
Peng L, Qi ST, Zhu WL. [Modified Reconstruction of the Cistern Magna for Treatment of Syringomyelia With Chiari Malformation: Clinical Analysis of 35 Cases]. Nan Fang Yi Ke Da Xue Xue Bao. 2009;29(2):284-8. PubMed PMID: 19246301.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Modified reconstruction of the cistern magna for treatment of syringomyelia with Chiari malformation: clinical analysis of 35 cases]. AU - Peng,Lin, AU - Qi,Song-tao, AU - Zhu,Wei-lin, PY - 2009/2/28/entrez PY - 2009/2/28/pubmed PY - 2010/4/30/medline SP - 284 EP - 8 JF - Nan fang yi ke da xue xue bao = Journal of Southern Medical University JO - Nan Fang Yi Ke Da Xue Xue Bao VL - 29 IS - 2 N2 - OBJECTIVE: To explore the surgical approaches, microsurgical techniques and therapeutic effect of modified cistern magna reconstruction for treating of syringomyelia with Chiari malformations. METHODS: The clinical data of 35 patients with syringomyelia complicated by Chiari malformations were retrospectively reviewed, and the patients' chief complaints, presenting symptoms, neurological and radiographic findings, surgical approaches, outcomes, and complications were analyzed. RESULTS: The radiographs revealed type I Chiari in 18 and type II Chiari malformations in these patients. Surgical treatment resulted in symptomatic improvements in 29 patients, and 6 patients showed no obvious changes in the symptoms after the surgery; 3 patients received subarachnoid shunting for syringomyelia. During the follow-up for a mean of 2 years, 32 patients showed obvious clinical improvement, and magnetic resonance imaging demonstrated complete spontaneous resolution of syringobulbia in 25 patients. CONCLUSION: Modified cistern magna reconstruction relieves brainstem compression and restores the pulsatile flow of the cerebrospinal fluid at the cervicomedullary junction. Cerebellar tonsil reduction is performed chiefly by electric coagulation and cauterization combined with subpial resection, and the integrity of the pia mater should be maintained as much as possible to avoid potential adhesion and recurrence. The median foramens and Luschka of the fourth ventricle have to be opened to recover normal CSF circulation. Arachnoidal suspension and placement of a patulous dural graft are also important. Modified reconstruction of the cistern magna can be a good option for treatment of syringomyelia complicated by Chiari malformations. SN - 1673-4254 UR - https://www.unboundmedicine.com/medline/citation/19246301/[Modified_reconstruction_of_the_cistern_magna_for_treatment_of_syringomyelia_with_Chiari_malformation:_clinical_analysis_of_35_cases]_ L2 - http://www.diseaseinfosearch.org/result/6981 DB - PRIME DP - Unbound Medicine ER -