Chiari surgery

[rita804]

My mother,age 63 years is diagnosed for basilar invagination;syringomelia,chiari malformation:she has no pain since last 2 years but her left hand fingers are having no sensitivity.The doctor mentioned of removing the cerebral tonsils but not going for shunt to remove the blocked syrinx in the cord extending from the vericomedullary junction to T8_9

I have a question on what post surgery care should be taken and wondering why doctor is not going for shunt

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[actressmouse]

Selma is right...my tonsils were "reduced" because they were entangled in cranial nerves.

[selmaS]

  Hi and welcome to the Chiari forum.

Actressmouse is correct in that the decompression surgery is done to help reduce the size of a syrinx, it is done b4 a shunt is considered many times bcuz the syrinx 's r too small for a shunt or a stent....and a syrinx is the result of an obstruction to the CSF flow, with the decompression more room is made to allow flow....this should keep the syrinx from getting larger.

Shunts can malfunction, and get blocked and r only used  if needed, meaning the PFD did not allow for the syrinx to shrink.

As actressmouse mentioned we all need to rule out related conditions like EDS as these underlying conditions can affect how we feel and heal post op.

Not all Chiari Drs remove the tonsils, they only make room for the CSF to flow and allow the tonsils to remain...most times they remove them if they r  wrapped around other internal structures and this is done to remove ne issues that may cause.

Find out what all they plan on doing, lamenectomy, duraplasty and if so what type of patch...bcuz for those with EDS this can cause more issues and precautions must be practiced.

[actressmouse]

I had everything your Mom has EXCEPT syringomelia.  Perhaps the doc feels that the syrinx will go away once the brain is decompressed?  My cerebellar tonsils were REDUCED, but not removed...that procedure eliminated the herniation and opened up the foramen magnum.  In addition, I had skull to c2 fusion which lifted the skull off of my odontoid process by approx. 2 mm.  Post surgery care varies depending upon how your Mom handles the surgery.  I needed supervision for meds and activities of daily living for the first month.  Has Mom been checked for a co-morbid connective tissue disorder?  I have EDS/Stickler's Syndrome which allowed my skull to "settle" on the odontoid process in the first place.  You'll want to make sure all is investigated before going forward with surgery so that the right surgical protocol is followed.  My EDS changed the protocol and added the fusion.