Chiari Malformation, Dr. Jho's Chiari Malformation Surgery via small skin incis

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Chiari Malformation, Dr. Jho's Chiari Malformation Surgery via small skin

incision

Here is Dr. Jho's site. He does do minimally invasive surgery for chiari

malformations. But I don't know that it really works. It appears he does the

traditional surgery but without the large incision. Correct me if I'm wrong. I

still believe in Dr Milhorat's protocol rather than the traditional. He does

minimally invasive sugeries for all kinds of brain and spinal disorders.

Jho Institute for Minimally Invasive Neurosurgery

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Spine Diseases

Cervical disc herniation

Cervical stenosis

Thoracic disc herniation

Lumbar disc herniation

Lumbar stenosis

Spinal cord tumors

Occipital neuralgia

Spinal instability

Chiari malformation

Hyperhidrosis

Brain Diseases

Pituitary tumors

Cushing's Disease

Acoustic neuromas

Meningiomas

Craniopharyngiomas

Pineal tumors

Skull base tumors

Chordomas

Arachnoid cysts

Colloid cysts

Hydrocephalus

Trigeminal neuralgia

Hemifacial spasm

Vertigo and tinnitus

Glossopharyngeal

neuralgia

Spasmodic torticollis

Cerebral aneurysms

Chiari Malformation, Dr. Jho's Chiari Malformation Surgery via small skin

incision

A Minimally Invasive Neurosurgery : Dr. Jho's Endoscopic Chiari

Decompression for Chiari Malformation

Hae Dong Jho, M.D.& Ph.D., Professor of Neurosurgery

Jho Institute for Minimally Invasive Neurosurgery

Dr. Jho's endoscopic Chiari decompression

Instead of conventional decompression surgery via a large skin

incision and extensive tissue dissection, Dr. Jho places a 1.5 cm trocar via a

2-cm skin incision. Under direct endoscopic visualization, suboccipital

craniectomy and appropriate cervical laminectomy is carried out followed by

dural patch graft with the use of dural closure microclips.

Overview

Chiari malformation is a condition in which the brain tissue of the

cerebellar tonsils has herniated into the cervical spinal canal. In the

original description, four different types of this congenital malformation were

reported. Type I is the mildest form which consists of the cerebellar tonsils

being displaced into the cervical spinal canal. This condition can impair

cerebrospinal fluid (CSF) circulation and can compress the brainstem or spinal

cord. Type II consists of downward displacement of the brainstem into the

spinal canal in addition to downward displacement of the cerebellar tonsils. It

occurs most commonly with the congenital anomaly of meningomyelocele and spina

bifida. Type III is a combined condition of Type II with cervical meningocele.

Type IV involves underdevelopemnt of the cerebellum.

The adult form of Chiari malformation is usually Type I. Because of

CSF circulation blockage by Chiari malformation, CSF can accumulate in the

spinal cord itself and cause syringomyelia. Hydrocephalus can develop as well.

Syringomyelia is a condition in which the spinal cord is distended because of

fluid accumulation in the spinal cord itself. When syringomyelia accompanies

Chiari malformation, it commonly occurs in the cervical spinal cord.

Syringomyelia can cause pain, numbness, difficulty in use of the arms or legs,

muscle loss in the hands, and bowel and bladder disorder. When Chiari

malformation causes compression at the brainstem and spinal cord, it can cause

difficulty in swallowing, eye movement disorder, headaches, vertigo, balance

disorder, muscle atrophy of the arms and hands, spasticity of the legs, gait

disorder, and bowel and/or bladder disorder.

Classic conventional treatment is surgical decompression that

consists of bone removal at the occipital bone and spine, and enlargement of

dural covering at the craniospinal juncture with dura graft placement.

Syringomyelia usually resolves when adequate Chiari decompression is performed.

If syringomyelia does not resolve by Chiari decompression, a shunt catheter has

to be placed in order to drain the accumulated fluid in the spinal cord.

Dr. Jho performs Chiari decompression with minimally invasive

endoscopic techniques. With endoscopic techniques, the Chiari decompression

procedure is performed via a small incision, but achieves adequate decompression

as conventional microscopic decompression does. The minimally invasive

endoscopic decompression enhances a patient's quick recovery with less

postoperative pain and a shorter hospital stay than in conventional procedures.

For referral information or appointment for consultation contact:

Manager: Robin A. Coret

e-mail : rcoret@...

Tel :

Fax :

Address : JHO Institute for Minimally Invasive

Neurosurgery

7th Floor, Snyder Pavilion

Allegheny General Hospital

320 East North Avenue

Pittsburgh, PA 15212-4772

Contact Dr. Jho via e-mail DrJho@...

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Copyright © 2002 by Mi-Ja Jho, B.E.,

Hae-Dong Jho, M.D., Ph.D.

Jho Institute for

Minimally Invasive Neurosurgery

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