I didn’t get a duraplasty. could that have any reason why my symptoms are returning?
Could be. One way many people assess anatomical improvement after surgery is a cine MRI. In my practice, if flow is still obstructed on cine MRI after decompression, I discuss the possiblity of re-operation. If flow is good, I recommend medical management(neurology). That is not cut and dried but that is the best science we have on Chiari currently. Certainly, if the dura was not opened, the position of the cerebellar tonsils will not change(again, unless you do something else, e.g. ventriculo-peritoneal shunt).
I generally quote a 60% success rate in symptom reduction without duraplasty, 80% with(in appropriate patients, e.g. classic symptoms, reduced flow on MRI, failure of medical management, etc). To my knowledge, there is no literature in terms of symptom recurrence based on dural opening.
if something was wrong with my csf flow how is that resolved? … if it’s because the dura wasn’t opened, will I probably need more surgery?
Yes, if CSF flow is not restored, repeat operation is usually recommended.
thanks for all the help. still really nervous. but at least I know a couple things I can maybe expect now. if I told you my symptoms could you maybe get an idea of if you think it’s csf or something else? my symptoms are
headache -back/top/behind eyes
nausea
incision burning feeling
neck pain
back pain
back spasms - lower left side
arm pain/numbness
leg pain/numbness/weakness
dizziness/off balance
right side facial pain
drooling a lot
ringing in the ears
If you review Chiari symptoms, so many things can be caused by Chiari that it becomes difficult to tell.
Could many of those symptoms be caused by Chiari? Yes. Are they in your case? I don't know.
It is certainly time to go back to the treating MD and discuss your symptoms. You may want to ask about a cine MRI prior to your visit, as they may want to get it before seeing you to save some running around. Some MDs don't use cine MRIs, in which case I would suggest asking if they feel any other tests are appropriate prior to your visit.
when I emailed my surgeon last month he said te symptoms are nothing to worry about and no imaging was needed.