Objective The aim this study is to present the results of the minimal invasive neuroendoscopic-assisted system application as an alternative to traditional surgery in patients with Chiari malformation type 1 (CM type 1) with/without syringomyelia.

Design, Setting, and Participants In the study, data of 22 symptomatic patients were prospectively collected. Before and after the operation, patient characteristics, computed tomography, magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) flow dynamics MRI, and outcome scales scores were recorded. Foramen magnum decompression and C1 total laminectomy were performed. The fibrous band at the craniocervical junction was opened and a durotomy was performed. In patients with a syrinx, the pre- and postoperative axial and sagittal lengths of the syrinx were measured and compared.

Results The mean age of the patients was 32 ± 5 years. There were eight male patients. Ten patients had syrinx. The mean visual analog scale (VAS) score before and after surgery was 8 ± 1.06 and 2.18 ± 1.13, respectively. When evaluated according to the Chicago Chiari Outcome Scale, there was improvement in 20 patients, while there was no change in 2 patients. Syrinx resolved completely in 3 of 10 (13.6%) patients with syringomyelia, and the syrinx volume decreased in 3 patients (13.6%). In 4 of 10 (18.1%) patients, there was no significant change in the syrinx volume. The average operation time was 105 minutes (80–150 minutes). The average blood loss was 40 mL (20–110 mL).

Conclusion Although the study was limited due to the small number of patients with a short follow-up, endoscopic decompression was a safe and effective technique for surgery in CM type 1 patients.

目的 本研究的目的是展示微创神经内窥镜辅助系统应用作为传统手术替代方案治疗伴有/不伴有脊髓空洞症的 Chiari 畸形 1 型（CM 1 型）患者的结果。

设计、背景和参与者 在该研究中，前瞻性收集了 22 名有症状患者的数据。手术前后记录患者特征、计算机断层扫描、磁共振成像（MRI）、脑脊液（CSF）流动动力学MRI和结果量表评分。进行了枕骨大孔减压和C1全椎板切除术。打开颅颈交界处的纤维带并进行硬脑膜切开术。在患有空洞的患者中，测量并比较了空洞术前和术后的轴向长度和矢状长度。

结果 患者的平均年龄为 32 ± 5 岁。其中有八名男性患者。十名患者出现空洞。手术前后的平均视觉模拟评分（VAS）评分分别为8±1.06和2.18±1.13。根据芝加哥 Chiari 结果量表评估，20 名患者有改善，2 名患者没有变化。10 名脊髓空洞症患者中有 3 名（13.6%）的空洞完全消失，3 名患者（13.6%）的空洞体积减少。10 名患者中有 4 名 (18.1%) 的滴管体积没有显着变化。平均手术时间为 105 分钟（80-150 分钟）。平均失血量为 40 mL (20–110 mL)。

结论 尽管由于患者数量少且随访时间短，该研究受到限制，但内镜减压是 1 型 CM 患者手术安全有效的技术。