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RISS 인기검색어
- 검색키워드
- 주제어 : Craniovertebral malformation (검색결과 3 건)
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Akakin, Akin,Yilmaz, Baran,Eksi, Murat Sakir,Kilic, Turker The Korean Neurosurgical Society 2015 Journal of Korean neurosurgical society Vol.57 No.4
Chiari type I malformation is a tonsillar herniation more than 3 mm from the level of foramen magnum, with or without concurrent syringomyelia. Different surgical treatments have been developed for syringomyelia secondary to Chiari's malformations: craniovertebral decompression with or without plugging of the obex, syringo-subarachnoid, syringo-peritoneal, and theco-peritoneal shunt placement. Shunt placement procedures are useful for neurologically symptomatic large-sized syrinx. In this paper, authors define the first successful treatment of a patient with syringomyelia due to Chiari type I malformation using a pre-defined new technique of syringo-subarachnoid-peritoneal shunt with T-tube system.
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Harsh Deora,Sanjay Behari,Jayesh Sardhara,Suyash Singh,Arun K. Srivastava 대한척추신경외과학회 2019 Neurospine Vol.16 No.2
Chiari I malformation is characterized by the downward displacement of cerebellar tonsils through the foramen magnum. While discussing the treatment options for Chiari I malformation, the points of focus include: (1) Has the well-established procedure of posterior fossa decompression become outdated and has been replaced by posterior C1–2 stabilization in every case? (2) In case posterior stabilization is required, should a C1–2 stabilization, rather than an occipitocervical fusion, be the only procedure recommended? The review of literature revealed that when there is bony instability like atlantoaxial dislocation (AAD), occipito-atlanto-axial facet joint asymmetry or basilar invagination (BI) associated with Chiari I malformation, one should address the anterior bony compression as well as perform stabilization. This takes care of the compromised canal at the foramen magnum and re-establishes the cerebrospinal fluid flow along the craniospinal axis; and also provides treatment for CVJ instability. In the cases with a pure Chiari I malformation without AAD or BI and with completely symmetrical C1–2 joints, however, posterior fossa decompression with or without duroplasty is sufficient to bring about neurological improvement. The latter subset of cases with pure Chiari I malformation have, thus, shown significant (>70%) rates of neurological improvement with posterior fossa decompression alone. A C1–2 posterior stabilization is a more stable construct due to the strong bony purchase provided by the C1–2 lateral masses and the short lever arm of the construct. However, in the cases with significant bleeding from paravertebral venous plexus; a very high BI, condylar hypoplasia and occipitalized atlas; gross C1–2 rotation or vertical C1–2 joints with unilateral C1 or C2 facet hypoplasia, as well as the presence of subaxial scoliosis; maldevelopment of the lateral masses and facet joints (as in very young patients); or, the artery lying just posterior to the C1–2 facet joint capsule (being endangered by the C1–2 stabilization procedure), it may be safer to perform an occipitocervical rather than a C1–2 fusion.
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조병일 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.3
Author proposes the surgical management of symptomatic abnormalities of the cranio-cervical junction, prelimiarily. Experience with 20 case is presented. Simple X-ray, myelography, tomography and CT revealed etiology and mechanism of compression of the cervicomedullary junction, as well as it's reduciblity. Stabilization was the goal in the treatment of reducible lesions. Decompression of the cervico-medullary junction followed by stabilization was paramount in irreducible cases.
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