Wear flat-heeled shoes with closed backs.Dress in freshly washed, loose-fitting clothing. You may take permitted medicines with a small sip of water. (Avoid getting CHG in eyes, ears, nose or genital areas.)ĭon’t eat or drink after midnight before surgery (unless the hospital tells you otherwise). It kills bacteria and reduces surgical site infections. You may be asked to wash your skin and hair with Hibiclens (CHG) or Dial soap before surgery. Stop using nicotine and drinking alcohol 1 week before and 2 weeks after surgery to avoid bleeding and healing problems. Stop taking all non-steroidal anti-inflammatory medicines (ibuprofen, naproxen, etc.) and blood thinners (Coumadin, aspirin, Plavix, etc.) 7 days before surgery. Consult your primary care physician about stopping certain medications and ensure you are cleared for surgery. Presurgical tests (e.g., blood test, electrocardiogram) may need to be done several days before surgery. Discuss all medications (prescription, over-the-counter, and herbal supplements) that you are taking with your healthcare provider. Next, you will sign consent forms and complete paperwork to inform the surgeon about your medical history (i.e., allergies, medicines, vitamins, bleeding history, anesthesia reactions, prior surgeries). A Chiari malformation obstructing CSF flow (confirmed by cine MRI) and is causing severe or worsening symptoms.ĭuring the office visit, the neurosurgeon will explain the procedure, its risks and benefits, and answer any questions.An abnormal collection of CSF in the spinal cord called a syrinx.You may be a candidate for surgery if you have: Rods and screws are inserted to structurally reinforce the skull and neck vertebrae. Spinal fusion may be performed in addition to posterior fossa decompression surgery in certain patients with spine instability due to scoliosis, Ehler-Danlos syndrome, or other bone abnormality. It's also important to understand that some minimally invasive techniques used for children (whose skulls are still growing) may or may not be appropriate for adults. The amount of bone removal should be the same in any procedure, endoscopic or standard "open" technique. Despite what the words "minimally invasive" suggest, the amount of bone removal needed to effectively restore normal CSF flow depends on the individual patient's anatomy and size of Chiari. Minimally invasive can mean different things: shorter skin and muscle incision, no dura opening, no shrinkage of the tonsils, or use of ultrasound and endoscopes. Many patients ask about minimally invasive or endoscopic surgery. The concept is similar to letting out the waistband on a tight pair of pants. A dura patch is sewn to expand the space for cerebrospinal fluid to flow around the tonsils.
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