Chiari malformation treatment with decompression surgery

Decompression surgery is the primary method of Chiari malformation treatment. It involves widening the bone canal, reducing pressure on soft tissues, and addressing issues with cerebrospinal fluid. It is a complex procedure due to the operating field's small size and the high concentration of essential nerves and pathways. The aim is to widen the narrow passage in the skull by removing the lower part of the skull bone and the posterior part of the first cervical vertebra. It allows the cerebrospinal fluid to flow freely without any blockage. Under general anesthesia, the neurosurgeon removes a section of the occipital bone. Then, he expands the large occipital opening and the back of the upper cervical vertebrae (laminectomy) to the level of sagging brain tissue. In addition, the doctor eliminates compression of brain structures by resecting the tonsils of the cerebellum, normalizing cerebrospinal fluid circulation. The dura mater is opened as part of the procedure, and a synthetic material or the patient's tissues, such as hip fascia, are sewn into the incision. It helps with the circulation of cerebrospinal fluid. In some cases, shunts are installed that drain fluid into the chest or abdomen. In addition, physiotherapy expedites the healing process after the Chiari operation.