Consensus conference on Chiari: a malformation or an anomaly? Scoliosis and others orthopaedic deformities related to Chiari 1 malformation
Consensus conference on Chiari: a malformation or an anomaly? Scoliosis and others orthopaedic deformities related to Chiari 1 malformation
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DOI：
10.1007/s10072-011-0689-y
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发表时间：
2011-09
影响因子：
3.3
通讯作者：
Luca F. Colombo;F. Motta
中科院分区：
文献类型：
--
作者：
Luca F. Colombo;F. Motta
在本文中，我们分析了 Chiari I 型畸形患者的骨科畸形以及保守或手术治疗。这些患者最常见的畸形是脊柱侧弯。不同的研究表明，脊髓空洞症与脊柱畸形之间存在因果关系，而脊柱畸形的类型因畸形类型而异：无症状的脊柱侧弯的特点是单侧弯曲和向左凸的发生率较高，而有症状的脊柱侧弯的特点是双胸腰段弯曲。这些患者的支具保守治疗效果不佳，而且脊柱侧弯通常会逐渐发展。国际数据证据表明，对于没有脊髓脊膜膨出或先天性脊柱侧弯，但患有 Arnold Chiari I 畸形和脊髓空洞症的患者，枕下颅骨切除术是减少空洞和改善脊柱侧弯的最佳机会，特别是对于 10 岁以下且 Cobb 角低于 30° 的儿童。晚期减压或渐进弯曲的矫形治疗是脊柱关节融合术。
In this article, we analysed the orthopaedic malformation in patients affected by Chiari I malformations as well as conservative or surgical treatment. The most common deformity in these patients is scoliosis. Different studies suggest a causal relation between syringomyelia and spinal deformities that differ by the type of deformities: asymptomatic scoliosis is characterized by a higher incidence of a single curve and convexity to the left, while symptomatic scoliosis is characterized by a double thoracolumbar curve. The conservative treatment with brace in these patients is not effective and scoliosis is typically evolutive. The evidence of the international data is that in patients without myelomeningocele or congenital scoliosis, but with Arnold Chiari I malformation and syringomyelia, suboccipital craniectomy gives the best chance for syrinx reduction and scoliosis improvement, particulary in children younger than 10 years and below a Cobb angle of 30°. The orthopaedic treatment in late decompression or in progressive curve is spine arthrodesis.