What Is Involved in Chiari Malformation Surgery?

A chiari malformation is a type of birth defect that involves the portion of the brain responsible for maintaining balance, and treatment often involves surgical intervention. The type of chiari malformation surgery performed depends on the severity of the defect as well as individual symptoms. In some cases, decompression surgery is used to remove a small portion of the skull or spine. In other situations, the protective covering surrounding the brain and spinal cord is cut, and extra tissue may be added in order to repair the deformity. Any questions or concerns about the most appropriate type of chiari malformation surgery for an individual situation should be discussed with a doctor or other medical professional.

Posterior fossa decompression surgery is the most common type of adult chiari malformation surgery. In this procedure, an incision is made on the back of the head, and a small portion of the skull is removed in order to relieve pressure on the spine. In some cases, part of the spinal column is removed as well, depending on the severity of the malformation. A separate procedure known as electrocautery may be performed at the same time and involves the use of electrical currents to destroy tissue.

A spinal laminectomy may be performed during chiari malformation surgery if part of the spinal column, known as the lamina, needs to be removed. This procedure increases the size of the spinal canal in order to relieve pressure on the spine and its associated nerves. The spinal laminectomy procedure is often performed at the same time as decompression surgery.

Infants and children who have a chiari malformation often have a birth defect known as a myelomeningocele. In this condition, some of the bones of the spine do not completely develop, causing a portion of the spinal column and surrounding tissue to protrude through the back. Surgery is required to close this abnormal opening.

Hydrocephalus, or fluid on the brain, is often present in a person with a chiari malformation and requires surgical intervention in order to reduce pressure inside the head. This type of chiari malformation surgery most frequently uses a tube known as a shunt, which drains the excess fluid from the brain and empties it into the chest or abdominal cavity for reabsorption into the body. Another type of hydrocephalus surgery involves a small cut into the third ventricle of the brain so that the excess fluid can escape.