Suboccipital decompression is a surgical procedure that creates more space at the junction where the skull meets the spine. It is most commonly performed for Chiari malformation, a condition where part of the brain extends downward through the opening at the base of the skull, compressing the brainstem and blocking cerebrospinal fluid flow.
Patients with Chiari malformation may experience headaches (especially with coughing or straining), neck pain, balance problems, numbness in the hands, difficulty swallowing, and sleep apnea. Suboccipital decompression addresses these symptoms by relieving the compression.
How the Procedure Works
Dr. Waldron performs the decompression through an incision at the back of the head and upper neck. A small portion of the skull bone at the base is removed, and in most cases the upper part of the first cervical vertebra is also trimmed. The dura may be opened and a patch sewn in to further expand the space.
- Removal of a small section of skull bone at the base
- Possible trimming of the C1 vertebral arch
- Duraplasty to expand the intradural space when needed
- Restoration of cerebrospinal fluid flow pathways
What Recovery Looks Like
Hospital stays are typically two to four days. Headaches and neck stiffness are common in the early postoperative period and gradually improve. Most patients notice improvement in their preoperative symptoms within the first few weeks to months. Activity restrictions are generally maintained for six to eight weeks.