关键词: Chiari-I型畸形, 脊髓空洞症, 术前评估, 手术方式

Abstract: Objective To establish a simple adult Chiari malformation type I (CM-I) preoperative scoring system and explore its clinical value.Methods A retrospective analysis of 79 adult CM-I patients undergoing surgery in our department from January 2016 to December 2019.All patients were evaluated using the CM-I preoperative AIC scoring system,and the corresponding operations were performed based on the evaluation results.Surgical complications were recorded.MR was followed up post-surgery and the patients' outcome was evaluated by the Chicago Chiari prognostic score.Results All patients were discharged from the hospital without death.None of the patients with bone decompression alone had any postoperative complications.The CSF-related complications including postoperative headache with fever (12cases) and incision cerebrospinal fluid leakage (1 cases) are the most common complications in the patients underwent subdural decompression and subarachnoid decompression.All patients were cured by adjusting antibiotics,combined with drainage of the lumbar cistern when necessary.73 patients were successfully followed up post-surgery in 6-45 months.The CCOS was used to calculate the symptom improvement rate,and the result was 92.6%.MR follow-up showed 3 cases had no change in the syringomyelia,mild progress in one case.To varying degrees,the syringomyelia decreased or even disappeared in the rest of the patients compared with the preoperative MR.Conclusion Considering the safety and effectiveness of surgery,the individual operation method based on preoperative AIC scoring system is effective in clinical practice.

Key words: Chiari malformation type I, Syringomyelia, Preoperative evaluation, Operation method