What Is Chiari Decompression Surgery?
Chiari decompression is a surgical procedure for a disorder known as Arnold Chiari malformation, which causes the brain tissues to protrude into the spinal canal. The disorder may be present at birth or appear as the brain and skull develop.
Who Needs Chiari Decompression Surgery?
If you have a syrinx or a Chiari malformation that obstructs CSF flow and is causing severe or worsening symptoms, surgery may be recommended. Surgery is typically reserved for those with persistent headaches, other severe symptoms, or unusual results from a neurological examination.
Procedure
After you are asleep, the procedure starts with a midline incision at the back of your head and extends to your upper neck. The incision is usually 5 or 6 cm long.
The muscles attached to your skull and spinal bones are elevated. Using a fine high-speed drill, a small window of bone (2.5cm diameter) is removed from the base of the skull. This creates more space for the cerebellum and decompresses the brainstem.
Because the tonsillar herniation frequently extends into the spinal canal, the posterior arch of the first cervical vertebra, C1, is also removed.
This procedure is often sufficient, and no further treatment is necessary. However, some special cases may need further treatment or surgery.
Recovery
After the procedure, the medical team will monitor your heart rate and blood pressure. In case of nausea or headache following surgery, medication will be administered.
Most patients are able to go home 1 – 2 days after surgery. During the first 24 to 48 hours, make sure you have someone at home who can assist you. Always follow the care instructions provided by your surgeon.