One of the most common treatments for Chiari malformation is decompression surgery. If your surgeon has recommended either posterior fossa decompression or minimally invasive decompression surgery, you are likely curious about what to expect during your recovery.
To ensure an easier recovery process, prepare as much as you can beforehand. By understanding what to expect in the days, weeks and months following your treatment, you can plan ahead and focus your energy entirely on healing.
About Chiari Decompression Surgery
Chiari decompression surgery is performed to create more space within the skull and spine for the back portion of the brain known as the cerebellum. The reason you experience the symptoms associated with Chiari malformation is because your skull did not grow large enough to hold the entire cerebellum. As a result, it is pushing down through a hole in the base of the skull. This disrupts the normal flow of cerebrospinal fluid, which surrounds the brain and the spinal cord which can lead to fluid buildup in the spinal cord (syrinx, syringomyelia, hydromyelia). There may also be impingement on the brainstem, as well as the spinal cord. For these reasons, your doctor may recommend one of two types of surgical approaches.
Traditional Approach
The traditional method, posterior fossa decompression, is when the surgeon makes an incision and performs a craniectomy, in which he or she removes a section of the back of the skull and first cervical vertebrae. A small section of the membrane covering the brain, called the dura, is then opened and replaced that with a more flexible patch graft, creating the necessary space for the cerebellum.
Minimally Invasive Approach
The second approach is minimally invasive surgery. The surgeon will use microscopic visualization techniques and specialized instruments which allow him or her to make a much smaller incision. With this method, there is no need for a patch to be placed.
Whichever technique your surgeon uses, your recovery steps will be similar. However, if you are treated using a minimally invasive approach, you are more likely to experience a shorter recovery time and less postoperative pain.
Immediately Following Surgery
For about the first 24 hours after your procedure, you will remain in a room within the intensive care unit or similar area, where you will be monitored closely for signs of potential complication. When your healthcare team determines that you are stable, you will be moved to a neurological recovery floor.
Typically, patients spend a total of 2-4 days in the hospital, although some patients may require a longer stay. The duration of your stay depends on your personal circumstances and health status, as well as your individual surgery. If your surgeon has used a minimally invasive approach, your overall hospital stay, as well as the procedure itself, will likely be somewhat shorter than if he or she uses a traditional decompression approach.
Recovery at Home
Every patient’s recovery will vary, and your healthcare team will help you develop a post-surgery plan tailored to your needs. However, there are some aspects of recovery that most patients can expect to occur in the first few days, weeks and months.
The Days Following Surgery
During the first days at home, you will likely be given restrictions on certain activities, such as:
- lifting anything over a few pounds
- bending over
- chores around the house or home
- driving
- consuming alcohol
Though you may experience immediate improvement from some of the symptoms you had prior to your procedure, you will likely be given a prescription to help manage any post-surgical pain. When you pick up your medication, your pharmacist will discuss any further precautions or restrictions.
Expect to have follow-up visits with your healthcare team to monitor your Chiari decompression surgery recovery. If you have stitches or staples, you may need to have them removed.
The Weeks Following Surgery
As your Chiari decompression surgery recovery progresses, some of the restrictions you were given will be modified or lifted completely. Most patients are told to avoid strenuous exercise for an extended period of time, but your physician may ask you to do light exercises and/or begin physical therapy sessions.
You will likely experience increased relief from Chiari malformation symptoms with the passage of time and by following your care provider’s instructions. Follow-up visits will continue through this period, and your doctor will monitor your progress and make recommendations along the way.
The Months Following Surgery
Many people can return to work 6-12 weeks following surgery. This will vary on a patient-by-patient basis as it depends upon a number of things, including the severity of any remaining symptoms, any complications you may have experienced due to your surgery, or any other health conditions you may have and the demands of your workplace. Some people will return to work sooner than others, and your doctor will monitor your recovery and make recommendations based on your individual case.
With the passage of time, around 50% of patients fully recover and can resume all the activities they engaged in prior to surgery, and another 10-30% experience significant improvements in their preoperative symptoms.
Some patients will require physical therapy to aid their Chiari decompression surgery recovery. Your healthcare team will work with you during this time to strengthen your physical abilities and reduce any discomfort you experience.
Walking the Road to Recovery Together
Your recovery is just as important as the surgery itself. If at any time you have questions or concerns, discuss them with your healthcare team, and they will be happy to address them. Your team will be there for you during your entire recovery process, way beyond just your hospital stay.
