About Posterior Fossa Decompression
Normally the cerebellum (the part of the brain responsible for balance) is sheltered in a bony space near the bottom back of the skull. When this space is too small, though, the lower portion of the cerebellum may be pushed down into the spinal canal. Known as a Chiari malformation, the extension of the brain into the spinal canal can impair the flow of spinal fluid and put pressure on both the brain and the spinal cord.
While not all instances of Chiari malformation cause problems, symptoms can sometimes be debilitating. In those cases, surgical techniques can be used to reduce the pressure on the brain and spinal cord. Posterior fossa decompression – the removal a small portion of the skull (suboccipital craniotomy) and spine (cervical laminectomy) to give more room for the brain and spinal cord – is a procedure used to address symptomatic Chiari malformation.
Goals of Posterior Fossa Decompression
Headaches, balance problems, numbness, tingling, weakness and even speech and vision problems can all occur as a result of Chiari malformation. The aim of Posterior fossa decompression is to halt the progression of damage to the brain and spinal cord by providing room for the cerebellum outside of the spinal canal and restoring the natural flow of spinal fluid while also hopefully alleviating some of the symptoms experienced by the patient.
How Posterior Fossa Decompression is Performed
Posterior fossa decompression is a surgical procedure performed under general anesthesia. In preparation for the procedure, a portion of your scalp near the base of the skull is shaved. The head is also secured to prevent movement.
In order to access the affected portion of the skull, the surgeon makes an incision along the back of your head and extending down to the upper neck. The upper neck muscles and other soft tissues are then gently peeled back to reveal the skull and first vertebrae. At this point the surgeon uses a precision cutting tool, known as a high-speed cutting burr, to carefully remove a small section of bone at the base of the skull through a procedure called a suboccipital craniectomy, creating more space for the brain and spinal cord. The surgeon also may remove the bony roof of one or more vertebrae in a procedure known as a cervical laminectomy to provide additional pressure relief for the brain and spinal canal.
While posterior fossa decompression surgery only takes a few hours to complete, you’ll need to plan on adjusting your activities for the next several weeks to allow for recovery.
Following the procedure, you’ll most likely spend two to four days at the hospital. Some soreness and discomfort is common during this period, although pain medication should help alleviate the discomfort. Upon returning home, it’s important to continue allowing yourself to heal by avoiding any strenuous activities – including lifting anything greater than five pounds or any fast movements of the head and neck – for at least six weeks.
Improvement in symptoms may begin to occur shortly after the surgery, although especially for concerns such as numbness and weakness, the improvement may be gradual and occur over the course of several months.
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 specific kinds of conditions and who 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.