Does anyone have any thoughts or experience with fusion surgery in a young child? What should we anticipate during recovery with fusion+decompression? My son is 5 and has Chiari I, retroflex odontoid, brainstem herniation and central sleep apnea. We've seen several NS's who all recommended a standard Posterior Fossa Decompression. However, the most recent NS just recommended this PLUS fusion surgery. The reasoning he said NOT to decompress without fusion is that it will create further instability of the occipitoatlanto-axial joint and will aggravate the existing brainstem herniation, etc. At the same time, I'm hesitant because he has so much growth ahead of him that may complicate this. Thanks.
I would suggest asking to speak with a patient who has undergone the procedure the most recent neurosurgeon is recommending. Certainly, progression of disease is a risk(but rarely is it a certainty). It sounds like you have"several" neurosurgeons who made a less aggressive recommendation, and another neurosurgeon, who made a different recommendation.
If the most aggressive neurosurgeon has difficulty linking you to a satisfied patient who underwent a similar procedure, that may be a red flag.
the posterior elements removed in a typical decompression add about 10% to full spinal stability. Most patients tolerate the procedure well.