Questions for your Surgeon

 

You've been diagnosed with Chiari malformation, and surgery is now on the table. So—what should you ask your neurosurgeon?

This is a critical step. Many people unfortunately end up needing revision surgeries because their initial operation was done by a neurosurgeon who wasn't truly experienced with Chiari. Chiari is highly specialized, and not every neurosurgeon has the expertise required for the best outcomes.

In fact, most true Chiari specialists are concentrated in major metropolitan areas. If you're not receiving care in one of these centers of excellence, it's important to pause and evaluate. Choosing the wrong surgeon could mean unnecessary complications and long-term setbacks.

So before you commit to surgery, ask the right questions. Your first priority: confirm your neurosurgeon is a true Chiari expert.

Here are some key questions that can help you do just that.

🧠 Experience & Specialization

1. How many Chiari decompression surgeries do you perform per year?
   (Look for someone who does many per year, not just a few.) For reference, my surgeon does chiari decompressions at least 2x per month.
   
   

2. Is Chiari malformation a focus of your practice, or just one of many conditions you treat?
   
   

3. Do you have fellowship training or advanced specialization related to Chiari or craniovertebral junction disorders?
   
   

4. Can you walk me through your typical decompression technique for Chiari I malformation?
   (You're looking for confidence, clarity, and a method that includes duraplasty if needed.)

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📊 Outcomes & Safety

5. What is your rate of complications, including CSF leaks, infection, or need for revision surgery?
   
   

6. How do you determine if someone is a good candidate for decompression surgery?
   
   

7. What does your post-op follow-up care and monitoring look like?
   
   

8. Do you monitor for syringomyelia or tethered cord syndrome in your Chiari patients?

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📚 Knowledge & Thought Leadership

9. Do you or your team contribute to Chiari research or have any published studies on Chiari malformation?
   
   

10. Are you involved in any Chiari-specific professional organizations or conferences?

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💬 Patient Support & Communication

11. Can I speak to any of your past Chiari patients or read testimonials specific to this surgery?
    
    

12. What are the most common questions or concerns your Chiari patients have post-op, and how do you help them manage those?
    
    

13. What’s your approach if symptoms persist after decompression?

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🚨 Bonus Red Flag to Watch For:

• If a neurosurgeon minimizes Chiari or seems overly dismissive of your symptoms, they might not have deep experience.
  
  

• A true Chiari expert understands it’s not just about imaging, but clinical symptoms + quality of life.