Chiari decompression with no duraplasty... Anyone had this?

Went to Dr. Burson today for a 2nd opinion NS appointment... Went really well, I feel really comfortable with him and his knowledge of chiari.

He suggested a full spine (lumbar/thoracic) MRI so will have that done tomorrow. I asked about a CINE MRI and he said he sees no point in it bc he can clearly see I have blockage where the tonsils herniate past the foram magnum.

He suggest I have surgery but said he won't push it UNLESS MRI tomorrow shows a syrinx.

Question is... He said he does not cut the dura and expose the brain, what he does is... There is 2 layers to the dura, he peels away one layer and very lightly thins the 2nd so the brain is still protected but this leaves the dura able to expand. He says this lowers the risk tremendously, mainly infection to brain or spinal cord, stroke, meningitis, etc. Lowers hospital stay from 4-5 days down to 2.5 days.

Said he's been doing this way for the past 10 years and done it hundreds and hundreds of times and can count on one hand the people that had complications and all was just the need of a repeat surgery.

So what do y'all think, every other surgery I read about talked about removing or opening dura and replacing with a graft?

[selmaS]

Hi...I have heard of decompression without duraplasty, but too many of them do end up in a re-do surgery with the dura being opened...not sure if it is always a good idea, or y it does not work and needs the re-do....

Many times they do this with kids...feeling it is less invasive.....

I understand y so many go along with this as it does so promising.....less risk of infection sounds wonderful....and depending on what all is going on inside ur head will depend if this will be the right way to go.

"selma"

[christianirc]

How did Dr. Burson turn out for you?  I have an appointment to see him in about a month.

[Samanthab259]

Why do they open our dura? Keep in mind im still kinda new to this :)

[ajunebug]

Hi there! I just had decompression and did not have a duraplasty. The original plan pre-op was to do a duraplasty, but once the bone was removed (laminectomy and craniectomy), the doctor felt as though I had enough room for CSF flow. They did an ultrasound during my surgery and decided not to do the duraplasty. So far so good. I am 3 weeks post-op and doing great. :)

[zygy2]

I am sure it would be a case by case basis.  If he feel it would work for you than maybe that is your best route.  From what I read it is a lot less risk for complications but the biggest risk is that you need a re-do.  I had my dura opened and still need a red-do because of complications from my surgery so I guess it is an option no matter what.  After all the reading that I had done I wanted to have the dura opened, just seemed a better chance of "fixing" things but it sounds like where he removes one layer and just thins it that this is as close as you can get to actually opening the dura!  Sounds like a good option that not as many people get to choose.  I was also out of the hospital 48 hours post-op so it is possible to get out early :)  even with the dura opened!