Posterior Expansion And Decompression Of The Foramen Magnum Neck Pillow Autologous Iliac Bone Fusion And Internal Fixation Treatment Of Basilar Invagination The Clinical Curative Effect Of Observation

Objective: Through posterior expansion and decompression of the foramen magnumneck pillow autologous iliac bone fusion and internal fixation for basilar invaginationtreatment and study of the therapeutic effect for clinical operation, providing somereference.Methods: The statistics of patients in2010May~2013July in Shandong Universityof Traditional Chinese Medicine Affiliated Hospital spinal orthopaedic wardhospitalization and underwent a treatment of posterior expansion and decompression of theforamen magnum neck pillow autologous iliac bone fusion and internal fixation for Basilarinvagination. Selected one of16patients, functional exercised actively after surgery and regularfollowed-up, and collected Chamberlain line、McRae line、cervicomedullary angle、JOAscoring and other related data of these patients before and after operation, analyzed themretrospectively, and observed the therapeutic effect of surgical operation for the patientswith basilar invagination. Then the data were applied to perform statistical analysis.Results: Each patients were followed up with an average of1.1years (range0.5~2years).We found that the patients’ data such as Chamberlain line、 McRae line、cervicomedullary angle and JOA scoring were improved and relieved in different degrees.Chamberlain line was lowered from6.9188mm preoperatively to0.7813mmpostoperatively. McRae line was lowered from1.8125mm preoperatively to-2.6875mmpostoperatively. JOA scoring was increased from9.75preoperatively to13postoperatively. Cervicomedullary angle was added from139.6875°preoperatively to155.1250°postoperatively. There was a statistically significant difference in Chamberlain line、McRaeline、cervicomedullary angle and JOA scoring before and after the operation.Conclusion: The pulling action of intraoperative traction and neck pillow nail plateholder makes the atlantoaxial joint reset, expands the cervicomedullary angle, extenuatesthe oppression. Occipital-cervical fusion reduces local inflammation. The advantages ofthis surgical approach is: Fixation and fusion strengthen the stability of neck pillow. We donot need fixed plaster and skull traction because screw is strong and reliable. Ambulationwith cervical collar is allowed after the operation, which avoids complications caused byprolonged bed rest. Leakage of cerebrospinal fluid will not happen because we do not cutthe dural. Therapeutic effect of posterior expansion and decompression of the foramenmagnum neck pillow autologous iliac bone fusion and internal fixation for basilarinvagination is worthy of recognition. It is an effective methods for basilar invagination.