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As the day of your Chiari decompression surgery procedure approaches, knowing what to expect can help reduce some of the stress that goes along with undergoing any medical procedure. By understanding what will happen before, during and after your procedure, you can plan ahead and rest easy while focusing on your recovery.

Overview of Chiari Malformation

Most Chiari malformations are congenital, which means they have been present since birth. As your body grows, your brain and skull develop together, typically with just enough room within the skull to accommodate the brain. However, sometimes the skull does not grow large enough, and there is a mismatch between the size of the two body parts. This is what leads to a Chiari malformation.

Because it does not have enough room, the lower part of the cerebellum gets pushed through the foramen magnum, a hole at the base of the skull through which the spinal cord and blood vessels pass. The protruding parts of the cerebellum are known as cerebellar tonsils.

Sometimes the cerebellar tonsils can block the flow of cerebrospinal fluid, creating a buildup of pressure that leads to symptoms. The cerebellar tonsils may also impinge on the spinal cord. The goal of your upcoming Chiari decompression surgery procedure is to relieve any pressure and/or impingement by increasing the amount of space available for the soft tissues.

Preparing for Chiari Decompression Surgery

In the days leading up to your Chiari decompression surgery procedure, your doctor may temporarily adjust the dosage of any medications you are taking. It is important to tell your doctor about any medications or supplements you have been taking, whether over-the-counter or prescription, so your doctor can inform you of any necessary modifications.

Additionally, your doctor will give you guidelines for your food and liquid intake the night before your procedure. These guidelines are for your comfort and safety, and it is important that you follow them exactly. If you are unclear about any of your preoperative instructions, be sure to discuss your questions with your doctor before the day of your surgery.

Surgery Day

On the day of your surgery, dress comfortably and be sure to bring any essentials you want to have available during your hospital stay. Your doctor will give you specific directions, but expect to arrive about an hour before your scheduled procedure. This will give you time to get checked in and place your belongings in your room.

Once you are checked in, you will be taken to a preoperative room where your vitals will be checked and your history reviewed by hospital staff. Your doctor will consult with you before the procedure and review the surgical plan with you again. During the procedure, you will receive general anesthesia to ensure you are completely comfortable.

The Procedure

The procedure you will undergo is called dural-opening Chiari decompression. First, to access the area, the surgeon will make a small incision and remove a section of bone from the back of your skull. Next, the surgeon will open a portion of the dura, the protective membrane that covers the brain.  Then a patch, harvested from your own tissues or donor tissues is attached to the dura, which helps increase the available space for your brain.

Your doctor may also perform a cervical laminectomy. In this procedure, the surgeon removes a small portion of your uppermost vertebra to create more space for your spinal cord, relieving pressure and helping prevent further damage.

The surgeon will then repair the soft tissues at the incision site using sutures or staples, and you will be moved to another room to recover from the general anesthesia. Your health care team will monitor your blood pressure, heart rate and breathing rate in the recovery room. Once you are stable, you will move to your hospital room for additional monitoring.

Following The Procedure

After your surgery, you can expect to spend approximately one week in the hospital recovering. During this time, you will gradually increase the amount of physical activity you do until your doctor decides you can continue your recovery at home.

Once you leave the hospital, you will spend six to 12 weeks recovering before returning to work and resuming your normal daily activities. During this time, you will have follow-up visits and diagnostic imaging to assess your healing, and your doctor will gradually lift your activity restrictions. The schedule for this varies, and your doctor will give you a more specific idea of what to expect during your individual recovery period.

Knowledge Brings Peace of Mind

Now that you have a better understanding of what to expect in the time leading up to and following your Chiari decompression surgery procedure, it will be easier to relax and focus your energy on preparing for your procedure. If you find you still have any questions, be sure to bring them up with your doctor, so they can be addressed sooner rather than later. You will be glad you did, and your time leading up to your procedure will be more restful because of it.

Chiari malformation treatments