Surgical Statistics
Surgeries Performed at The Chiari Institute
The surgeries we perform are diversified and include:
- Posterior fossa decompression
- Posterior fossa revision
- Craniocervical fusion
- Tethered cord surgery
- Syringomyelia operation
- Numerous minor surgeries, including:
- Invasive surgical traction
- Ventriculoperitoneal shunt
- Anterior cervical diskectomy fusion
A surgical approach is greatly enhanced by the use of color Doppler sonography and morphometric measurements.
Two Experienced Surgeons Present at Each Operation
The Chiari Institute has the advantage of using two experienced surgeons during each surgery, working as a team. Other centers usually use one experienced surgeon who is helped by a resident, P.A., nurse or junior attendant with far less experience. The use of two co-surgeons at The Chiari Institute allows us to minimize the risk of intraoperative complications and also allows the surgeons to push the envelope and to perform safe surgical feats that are otherwise hard to achieve by other teams.
Specialization Means Expertise
Since Chiari-related surgeries are performed daily at The Chiari Institute, our surgeons benefit from the concept of full immersion. They have been exposed to an endless series of anatomical variants and have faced and solved complex technical problems.
Complication Rates
The complication rate for Chiari-related surgeries at The Chiari Institute is the lowest in the nation.
To cite one example: The average complication rate for cerebrospinal fluid leakage is about 8% among expert neurosurgeons in the U.S. (with non-experts ranging from 25-45%). The risk of CSF leakage at The Chiari Institute (with the dura and the arachnoid open, plus a pericranial duraplasty) is normally 0.3%.
Redo Surgeries
49% of all surgeries performed at The Chiari Institute are redo surgeries from other institutions. The reasons for this are:
- The surgery resulted in complications.
- The surgery addressed the pathology but fell short of the intended effect.
- The surgery was total, but an important comorbidity (accompanying problem) was neglected at the time of diagnosis.
Minimally Invasive Surgery for CMI (Chiari I Malformation)
This article concerns a relatively recent variation to CMI surgery, which involves the opening of skull and C1, without Duraplasty. A number of pediatric neurosurgeons are the current main advocates for this procedure. Their case series is small, since they just started; so long term results are unknown. This procedure is intended for young children. Their point is that when the dura (and the arachnoid) is opened, there is an increased risk of CSF leaks, wound infection, and meningitis. The risk of CSF leak is about 8% nationwide (while it is just 0.2% at The Chiari Institute).
» Read the complete article by Dr. Bolognese (PDF)
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