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Dr. Bex

šŸ‘¤ Person
1494 total appearances

Appearances Over Time

Podcast Appearances

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

Most of the ones they use, right.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

So it's named that because of the Chiari Institute, but the idea is you correct everything in one fell swoop. So the idea is you do a Chiari decompression, which is where you remove the bone that is basically causing the pressure on the brainstem. So just because the brainstem is a little bit lower, the problem is it's trying to fit through a tiny little hole and that's where the pressure comes in.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

So it's named that because of the Chiari Institute, but the idea is you correct everything in one fell swoop. So the idea is you do a Chiari decompression, which is where you remove the bone that is basically causing the pressure on the brainstem. So just because the brainstem is a little bit lower, the problem is it's trying to fit through a tiny little hole and that's where the pressure comes in.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

So it's named that because of the Chiari Institute, but the idea is you correct everything in one fell swoop. So the idea is you do a Chiari decompression, which is where you remove the bone that is basically causing the pressure on the brainstem. So just because the brainstem is a little bit lower, the problem is it's trying to fit through a tiny little hole and that's where the pressure comes in.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

So you relieve it. That is the procedure of choice. When someone truly has a Chiari and truly is symptomatic, you do a decompression. But the idea is they do that in association with what is called a cranial cervical fusion. You attach the skull to the spinal cord. So you fuse it together using either rods or, you know, there's all different ways to do it. But they basically join it. They fuse it.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

So you relieve it. That is the procedure of choice. When someone truly has a Chiari and truly is symptomatic, you do a decompression. But the idea is they do that in association with what is called a cranial cervical fusion. You attach the skull to the spinal cord. So you fuse it together using either rods or, you know, there's all different ways to do it. But they basically join it. They fuse it.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

So you relieve it. That is the procedure of choice. When someone truly has a Chiari and truly is symptomatic, you do a decompression. But the idea is they do that in association with what is called a cranial cervical fusion. You attach the skull to the spinal cord. So you fuse it together using either rods or, you know, there's all different ways to do it. But they basically join it. They fuse it.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

So it's not so... It doesn't have as much mobility, which indirectly could cause symptoms. And then you do what's called an odontoid resection, which is part of your second cervical vertebrae. It sounds like they either realign it or they actually resect part of that vertebrae because the idea is it is also causing compression.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

So it's not so... It doesn't have as much mobility, which indirectly could cause symptoms. And then you do what's called an odontoid resection, which is part of your second cervical vertebrae. It sounds like they either realign it or they actually resect part of that vertebrae because the idea is it is also causing compression.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

So it's not so... It doesn't have as much mobility, which indirectly could cause symptoms. And then you do what's called an odontoid resection, which is part of your second cervical vertebrae. It sounds like they either realign it or they actually resect part of that vertebrae because the idea is it is also causing compression.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

The thing is, I looked it up, the risk of any Chiari decompression is like 1% to 5%. but up to 10% can have something called a CSF leak where afterward your spinal fluid can kind of be leaking because you're opening up a space that has fluid inside of it. So like 10% could have a leak.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

The thing is, I looked it up, the risk of any Chiari decompression is like 1% to 5%. but up to 10% can have something called a CSF leak where afterward your spinal fluid can kind of be leaking because you're opening up a space that has fluid inside of it. So like 10% could have a leak.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

The thing is, I looked it up, the risk of any Chiari decompression is like 1% to 5%. but up to 10% can have something called a CSF leak where afterward your spinal fluid can kind of be leaking because you're opening up a space that has fluid inside of it. So like 10% could have a leak.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

The fusion has a one to 4% chance of risk or of some bad outcome, but it's much higher, the higher in the spine you go, which makes sense. So the cervical spine, if you damage, I mean, anyone who knows if you injure or break something in your neck, you're from there down. If you do something in your lumbar spine, it's from there down.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

The fusion has a one to 4% chance of risk or of some bad outcome, but it's much higher, the higher in the spine you go, which makes sense. So the cervical spine, if you damage, I mean, anyone who knows if you injure or break something in your neck, you're from there down. If you do something in your lumbar spine, it's from there down.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

The fusion has a one to 4% chance of risk or of some bad outcome, but it's much higher, the higher in the spine you go, which makes sense. So the cervical spine, if you damage, I mean, anyone who knows if you injure or break something in your neck, you're from there down. If you do something in your lumbar spine, it's from there down.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

So the idea is the higher the fusion, the higher the risk because it controls so much more. And then the odontoid resection is a piece that is not very well reviewed or well studied so that we don't even know the risk factors.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

So the idea is the higher the fusion, the higher the risk because it controls so much more. And then the odontoid resection is a piece that is not very well reviewed or well studied so that we don't even know the risk factors.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

So the idea is the higher the fusion, the higher the risk because it controls so much more. And then the odontoid resection is a piece that is not very well reviewed or well studied so that we don't even know the risk factors.

Nobody Should Believe Me
Case Files 21: Rady Children’s Part 5

But so the people who are kind of naysayers of this or the neurosurgeons who kind of say something about this doesn't feel right is because you're taking multiple risky procedures, putting them into one procedure, under one anesthesia session, and then that there's really no consensus on why you got there in the first place, let alone consensus to do all of these things.