About Dural Opening Chiari Decompression
With Chiari malformation, the lower region of the brain (cerebellum) doesn’t fit inside the skull and extends into the spinal canal. Not everyone who has a Chiari malformation experiences problems, but in some cases, the defect puts significant pressure on both the brain and the spinal cord.
To help remedy these conditions, surgery can be performed to remove a portion of the skull (occipital bone) to give the brain more room, relieving the pressure on both it and the spinal cord. This procedure, known as a decompressive suboccipital craniectomy, may also be done in conjunction with a cervical laminectomy (removal of the bony roof of the spine) to provide additional space in the spinal canal.
Goal of Dural Opening Chiari Decompression
Although some symptoms of Chiari malformation (such as headaches) may be treatable through pain medication etc., problems with numbness, tingling, weakness and balance can be difficult to address without surgery. Continued pressure on the spinal canal can also cause progressive, and potentially permanent, damage to the spinal cord.
The goal of dural opening Chiari Decompression is to prevent further injury to the spinal cord by making space for the lower regions of the cerebellum outside of the spinal canal while also, hopefully, providing relief from some of the associated symptoms.
How Dural Opening Chiari Decompression Is Performed
Dural Opening Chiari Decompression is a surgical treatment done under general anesthesia. Once you are sedated and properly positioned, the surgeon shaves a small section of the scalp, then makes a short incision. Thin layers of soft tissue are then gently moved apart to reveal the base of the skull.
A surgical tool known as a high-speed cutting burr is used to carefully remove a portion of the skull, giving the brain more room through a procedure called a suboccipital craniectomy. The surgeon then opens the dura mater (the soft membranous covering of the brain and spinal cord.) A patch made of either natural or artificial materials is then applied to the region. If necessary, the surgeon may decide to provide additional decompression by also removing a section of the first cervical vertebra as well (cervical laminectomy).
Once the procedure is complete the soft tissues are repositioned and the original incision is closed using sutures and staples.
Once the procedure is complete you can expect to spend the next 2-4 days in the hospital for monitoring and recovery. Similar to most surgeries, some pain and swelling are normal, and pain medication is generally administered to help reduce the discomfort.
After discharge, it is important to continue giving your body a chance to heal. Walking and other non-strenuous activities may be resumed almost immediately, but anything that could cause rapid movement of the head or neck, or place strain on the supporting muscles, should be carefully avoided for up to six weeks. You should not plan on lifting anything greater than five pounds during this period. Driving, sports and other strenuous activities should likewise be postponed.
While some improvement in symptoms may be noticed shortly after the treatment is performed, the maximum benefit (especially for symptoms like weakness and numbness) may not be apparent for up to a year. It may be helpful to keep in mind that even if the surgery doesn’t fully eliminate symptoms, but rather stops their progression, it has likely prevented further permanent damage and should still be considered a success.
Why Choose Neurosurgeons of New Jersey
Deciding to undergo surgical treatment for a Chiari malformation can be stressful. Neurosurgeons of New Jersey is committed to making the process as comfortable as possible through an emphasis on communication, cutting-edge technology and true patient-focused care. We are one of the largest sub-specialized practices in the Tri-State area and are uniquely suited to meet the specific needs of Chiari malformation patients.
You’ll meet with surgeons who are focused exclusively on treating these conditions and have extensive experience in the highly specialized techniques required for success. Throughout your interactions with Neurosurgeons of New Jersey, you can expect to be treated with the kind of care and professionalism that has earned us a reputation as one of the northeast’s premiere neurosurgery centers.