Breaking it down

So the decompression is done, it was 7 hours (supposed to be 4!). He do really well. I will try to explain the procedure as best I can....

The reason for the procedure is that he has a Chiari Malformation. This means that his cerebellum is not where it is supposed to be. It has been pulled (or pushed, we think in Thomas'case) into the actual foramen magnum, which is the funnel like opening at the top of the spinal cord. This space is not big enough to hold the cerebellum and the nerves in the spinal cord and pressure is placed on everything, affecting function. In Thomas' case, we noticed a change in his breathing due to bi-lateral vocal cord paresis (basically he couldn't control his vocal cords because of the pressure from his Chiari). His breathing became stridorous and that is what lead us back to the hospital. If he was older other symptoms we would have noticed would have been trouble with fine motor coordination, balance, headaches and an overactice gag reflux. Most cases of Chiari are not symptomatic, but Thomas is in the lucky minority. Untreated this can be life threatening. What the neurosurgeon did was called a posterior fossa decompression surgery. He opened up the back of Thomas' head and removed a half moon shaped bone from the base of his skull. Once that is removed he cut through the dura to give the hindbrain room. He then decided that more room was needed so he went down to the vertebrate on the spine and cut into the top two vertebrate, removing the boney arch at the back of the top two vertebrate (C1 and C2), this is called a laminectomy. After this he also wanted to relieve a little more pressure, but didn't want to cut any more vertebrate as cutting into two of them will already give Thomas an uphill battle for head control and stability later. So what he did was cut C3, C4, and C5 and lift them up to cut the dura underneath. He then patched the dura back together to make it slightly larger and then laid the bones back down and sew them back together (little dude bones are so cartilaginous that a needle can penetrate them). This is called an osteoplastic laminoplasty. When he did this, the neuro-monitors they had on Thomas showed over a 100% improvement on some of their readings. This means in some areas he may have gained function that he didn't have before, which is incredible news. We won't really know the full effects of the surgery for some time, but as it sits right now it went well and he has to battle the road to recovery. The hardest part of that battle is managing the pain of a three month old that is not being fed....so is he hungry or is he uncomfortable from the collar or is he in pain? It's a guessing game. But we are hopefully in the home stretch of this match of Thomas vs. spina bifida and although it isn't a TKO, I think the decision is going to go overwhelmingly in favor of Thomas