Treatment of C1-2 instraspinal neoplasms by laminoplasty via posternmedial approach / 中华神经医学杂志

Objective To investigate the techniques and curative effects of laminoplasty via posternmedial approach in treating C1-2 instraspinal neoplasms.Methods Twenty-seven patients (15males and 12 females) with C1-2 instraspinal neoplasms,admitted to and performed laminoplasty via posternmedial approach in our hospital from January 2007 to December 2011,were chosen in our study.Their clinical data and treatment efficacy were summarized.Results Total excision was achieved in all patients,and no patient in this study died.Pathological diagnosis showed 21 having schwannoma,1 neurofibroma and 5 meningioma.Follow up for 6-48 months indicated that 1 patient could take care of himself and the other 26 patients could live normally.No cervical spine instability or tumor recurrence was found.Conclusion Posternmedial approach may be regarded as the first selection to resect C1-2instraspinal neoplasms; laminoplasty can keep the stability of spine.

Microsurgical treatment of Arnold-Chiari Ⅰ malformation combined with syringomyelia / 中华神经医学杂志

Objective To investigate the methods ofmicrosurgical treatment of Arnold-Chiari Ⅰ malformation combined with syringomyelia and their curative effects.Methods The clinical data of 185 patients with Arnold-Chiari Ⅰ malformation combined with syringomyelia,admitted to our hospital from January 1997 to June 2010 and received different surgical treatments,were summarized.The relationship between curative effects and operative methods were analyzed.Results When these 185 patients were discharged from our hospital,the clinical signs and symptoms eliminated in 156 (84.3％)and not changed in 29; no symptomatic deterioration and death were noted.One hundred and forty-seven patients were followed up for 3 months-12 years; symptoms disappeared or alleviated in 110 (74.8％),not changed in 26 and deteriorated in 11.The MR findings in 95 patients demonstrated that the cisternals reconstructed and expanded in 82 and the cavities in spinal cords reduced in 79.Conclusion Both posterior fossa decompression + duraplasty and removal of cerebella tonsils + plastic operation of cistern magna are effective and advisable methods in the treatment of Arnold-Chiari Ⅰ malformation combined with syringomyelia.