Treatment of complicated congenital Arnoid-Chiari's malformation by occipitocervical fixation and bone graft fusion

Abstract

Objective To investigate the effects of occipitocervical fixation and bone grafting fusion for the treatment of complicated congenital occipitocervical malformations.Methods A retrospective analysis of 21 cases of complicated occipitocervical malformation patients was performed.Seventeen cases underwent posterior cranial decompression bone grafting and fixation of occipital cervical fusion.Four cases underwent soft tissue and bony tissue resection,decompression of odontoid process reset decompression,posterior foramen magnum decompression,bone grafting and fixation of occipital cervical fusion.All patients were followed up by 3 months to 3 years.Results For the patient with atlantoaxial dislocation and the presence of intra-axial ventral,dorsal compression,good effects could be achieved through soft tissue and bony tissue resection,posterior foramen magnum decompression,bone grafting and fixation of occipital cervical fusion.There was no relationship between dural matter repair,cerebellum tonsil resection and final effects.For the patient with segmental syringomyelia,spinal cord subarachnoid drainage should be done.Conclusions Different operation scheme should be considered according to the anatomic variation and formation mechanism of complicated occipitocervical malformations to improve the long-term surgical effects. Key words: Congenital complex occipital malformation; Posterior fossa decompression; Fusion with iliac bone graft and internal fixation; Transoral approach decompression