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Syringomyelia with Craniovertebral Junction Anomaly including Chiari Malformation（TypeI）,Atlas Assimilation and Atlanto-axial Subluxation. Case Report
Tadatsugu Morimoto
※1
Toshinori Nakao
※1
Shoji Yabuki
※2
Toshiyuki Tsuruta
※3
Shin-ichi Kikuchi
※2
※1 Department of Orthopaedic Surgery,Saga Social Insurance Hospital
※2 Department of Orthopaedic Surgery,Fukushima Medical University School of Medicine
※3 Tsuruta Orthopaedic Clinic
We report an operated case of synringomyelia with craniovertebral junction anomaly. A 16-year-old female was admitted complaining of pain in her right upper extremity. X-ray films of the skull showed atlas assimilation and atlanto-axial subluxation. MRI showed a syringomyelia between C2 and T5 vertebrae levels. The patient underwent foramen magnum decompression（FMD）and atlanto-axial fixation. FMD was performed by a craniotomy of the posterior fossa and the removal of the outer layer of the dura mater. The re-establishment of the subarachnoid space at the cisterna magna and the pulslation of the tonsils were clearly demonstrated by intraoperative ultrasound（US）after FMD. After the operation,the patient's neurological symptoms improved. MRI showed a decrease in the size of the syrinx. Based on the findings of the above case,intraoperative US is considered to be a useful technological advance that permits the surgeons to tailor the steps of FMD according to patient-specific characteristics and variables.
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