Comparative Study Of Endoscopic And Microscopic Treatment Of Chiari Malformation Type Ⅰ

Objective:This thesis is aimed at,through analyzing the curative effect of CM-1 patients who were treated separately through endoscopic decompression of atlanto occipital joint and the reduction of atlanto occipital decompression under microscope,discussing the advantages and disadvantages of these two methods and providing a helpful information to choose the operative methods.Methods:96 cases,in total,of CM-1 patients treated by simple atlanto occipital decompression in Shanxi People’s Hospital neurosurgery from Jan 2007 to Jan 2016 were collected and divided into 2 groups according to their different operative methods.(Group A including cases of patients treated by endoscopic decompression of atlanto occipital joint,Group B including cases of patients treated by reduction of atlanto occipital decompression under microscope).The two groups were compared in aspects ofpreoperative clinical sign,intraoperative record,as well as postoperative recovery situations.These records were compared.T test is used to process measurement data while chi-square test is used to process enumeration data.Results:There were no death case or serious complication case in these groups.The patients was discharged without death or serious complications occurred.The symptoms of Group A were improved in 40 cases(95.2% of 42),and the symptoms were unchanged in2 cases(4.8% of 42 cases).The symptoms of Group B were improved in 48 cases(88.9%of 54 cases),and the symptoms were unchanged in 6 cases(11.1% of 54cases).Post-discharge follow-up were carried out by telephone,text messaging,outpatient review,mail and other means of return visit.The follow-up period was 6 months to 5years.SPSS17.0 software is used to processe data.Patients of Group A,in aspects of operation time,blood loss,hospitalization costs and other indicators,were shown to be better than those of Group B,and it can be found that p is less than 0.05 through the chi square test,with statistical significance.According to the CCOS evaluation standard,the difference of surgery effect and complications between Group A and Group B is not remarkable,with p more than 0.05.Conclusion:Both endoscopic surgery and microscopic surgery treat Chiari typeⅠatlanto occipital decompressioncan get the effect of reducing the pressure.But the endoscopic reduction of atlanto occipital pressure operation is more minimally invasive,less influencing to the stability of atlanto occipital.And it spends less time and cost for hospitalization.