If you are scheduled for decompression surgery for Chiari malformation, you may be wondering what recovery will be like. It's important to understand that the length of the recovery period for this type of surgery isn't set in stone as each patient is different, especially in regards to any damage that has occurred from the herniation of the cerebral tonsils into the foramen magnum and whether or not syringomyelia developed. One thing that most all patients can benefit from is physical therapy. Here are a few things to consider.
How is your mobility?
With the painful and debilitating headaches of Chiari malformation, most patients tend to be more careful in avoiding certain maneuvers that can aggravate the symptoms, such as bending over, moving quickly, or turning their head. This causes the under-use of some muscles, while other muscles over-compensate for the movements. For example, you may shrug your shoulders upwards as a way to protect your neck when the car you ride in turns corners.
Other common symptoms of Chiari malformation is numbness and a pins-and-needles feeling in the extremities. Some Chiari patients find it difficult to be mobile due to these symptoms, especially when they can occur at any given time. Therefore, part of your physical therapy may involve strengthening your muscles that have been affected by Chiari. Obviously, however, if any nerve damage occurred due to a syrinx in your spinal cord (syringomyelia), you will likely need extensive physical therapy.
How is your neck?
Your neck muscles will be affected by decompression surgery. The neurosurgeon will need to go through the neck muscles in order to reach the dura to decompress the brain stem. This trauma to the neck muscles will cause them to spasm as they heal after the surgery. The spasms can become quite painful, particularly considering that there are two sets of sutures in the area (one in the muscles and the other in the skin). Medication, particularly Valium, is often prescribed to combat muscle spasms in the neck after decompression surgery for Chiari malformation.
Typically, neurosurgeons give referrals for neck physical therapy at the first post-op follow-up appointment. However, sometimes physical therapy is not necessary for those who have strong neck muscles going into decompression surgery. If your decompression surgery is scheduled at a later date and you would like to strengthen your neck muscles pre-op, it is extremely important that you only seek physical therapy from someone who is well-versed in Chiari malformation.