Chiari malformation is a rare condition caused by a defect in the skull. If the skull does not grow as much as it should, the brain can become deformed and end up pushing down through an opening in the skull called your foramen magnum. This is also where your spinal cord leaves your head and descends down your spine. When that area of your brain slides into the foramen magnum, is can prevent the ideal flow of cerebrospinal fluid. This can cause head discomfort, headaches, vision issues and balance problems.
The good news is that chiari malformation can usually be treated with simple methods by an experienced neurosurgeon. There are a couple of different treatment options, and we explore all your potential options in today’s blog.
Open vs. Laparoscopic Surgery
When it comes to treating chiari malformation, the most common option is to have an operation performed. This can be done with a traditional open method, or with a minimally invasive technique. The goal of both operations are similar, as the surgeon will perform a decompression and cervical laminectomy, which will help to allow the normal flow of spinal fluid throughout the body.
While the traditional method was once considered the standard, more surgeons are moving towards the minimally invasive technique for a number of reasons. For starters, using the minimally invasive technique allows the doctor to make smaller incisions and disrupt fewer surrounding tissues. Other benefits include:
- Less bleeding
- Less pain during recovery
- Shorter recovery duration
- Shorter stay in the recovery ward post-op
- Less pain medications or a shorter time on medication
- Quicker return to work or activities
It’s also worth noting that in the vast majority of cases, individuals healthy enough to undergo a traditional operation for chiari malformation are also candidates for the minimally invasive operation.
Decompression and Laminectomy
Regardless of the method you choose, here’s a look at the two main techniques used during the operation and what they hope to accomplish.
The goal of the decompression operation is to increase the space in the area for the cerebellum and to restore normal flow of cerebrospinal fluid. This is done by accessing the back of the patient’s neck and removing a small piece of bone at the back of your skull. The surgeon then opens a section of your dura, which is a thin membrane that covers the brain, and expands the area using a special patch or another method. Afterwards, the patient spends about 2-4 days in the recovery ward while the surgical team keeps an eye on their vitals.
In conjunction with the decompression, the surgeon may also perform a cervical laminectomy, which involves removing a small portion of your uppermost vertebrae. This will help to create more space around the spinal cord and for the cerebellum, and in turn relieves pressure in the area.
Dr. Chang has performed both the traditional and minimally invasive types of chiari malformation surgery, and he can provide a neurological consult if you’ve been diagnosed with the condition. For more information or to set up an appointment at his office, call (651) 430-3800.