Chiari Malformation

At Nemours, we promise to do whatever it takes to treat children as we would our own. When your child comes to Nemours, we know you’re placing your trust in us. This trust and our dedication to improving the health of your child is what inspires us to provide exceptional care and the most satisfying experience possible.

Quality & Safety

Neurosurgery Outcomes

Specially trained in pediatric neurosurgery, our board-certified neurosurgeons at Nemours/Alfred I. duPont Hospital for Children use the most advanced surgical techniques and technology. We’re here to help kids of all ages, from newborns to teens, with injuries or conditions involving surgery of the brain, skull, spinal cord, spinal column, or other parts of the nervous system, which affect the nerves that travel through the entire body.

To help us gauge how we’re doing and identify areas where we need to make improvements, we keep track of our surgical outcomes (the results of our care). Then we compare ourselves to the outcomes at other children’s surgical programs across the country. And our results show that we’re committed to delivering top-quality care and truly treating all of the children we see as if they were our own.

Nemours Quality of Care Prevents Complications After Neurosurgery

What Does This Graph Mean?

Here’s how our 2010 pediatric neurosurgery results for three key outcomes compare to other top children’s surgical programs nationwide:

  • Unplanned return to the operating room: when kids had to have another surgery within 30 days because of problems with their previous operation; Nationwide, nearly three times as many children (on average) are having to come back for an unplanned neurosurgery procedure than they do here. Nationally, the rate is 19.4%, versus 6.6% at duPont Hospital for Children.
  • Non-infectious postoperative occurrences: when a child has complications or problems that happen after surgery and may involve the heart, lungs, eating); Again, we’re doing far better than the national average of 9.92% elsewhere, compared to our rate of just 5.3%.
  • Wound occurrences: when a child has complications with the surgical wound, such as infections); Nearly twice as many kids nationwide had wound problems 6.3%, versus only 2.63% here.

Our Excellence in Neurosurgical Care

Using state-of-the-art treatment options, we’re experts at helping children will all kinds of neurological needs from cysts to injuries affecting the brain, nerves, and spine, from birth defects to brain tumors. We also treat kids with:

  • craniosynostosis: happens when skull bones next to each other become fused together ahead of a child’s normal developmental schedule, causing the head to grow too much in other directions
  • chiari malformations: a brain abnormality that affects the lower part of the brain, called the cerebellum
  • tethered spinal cord: a collection of disorders affecting the spinal cord, which is attached to tissues around the spine
  • spina bifida: the incomplete development of the spinal cord and backbones
  • spasticity: stiff or tight muscles and exaggerated reflexes
  • brachial plexus injuries: happens to the network of nerves going from the spine to the shoulder, arm, and hand)
  • hydrocephalus: when spinal fluid doesn't drain properly resulting in a build-up of fluid in the skull (this is the most common pediatric neurosurgical disorder)

Some neurosurgical procedures typically done with “open surgery,” which requires larger “open” incisions, can be performed through tiny incisions an inch or smaller. And that often means shorter hospital stays, quicker recovery times, less pain and discomfort, reduced chance of infection and bleeding, plus much smaller scars. Of course, all of that usually means less worried parents.

One example of a type of minimally invasive procedure that helps reduce complications after surgery is called, “endoscopic third ventriculostomy (ETV).” Used to treat hydrocephalus, the surgery was actually pioneered by one of our former neurosurgeons.

The operation involves making a small hole in the bottom of the third ventricle (one of the spaces in the brain) and letting the extra cerebrospinal fluid flow out of the brain. By using this groundbreaking procedure, we’re helping children avoid having to get a shunt. With a shunt, one end of a flexible tube is surgically implanted into a ventricle of the brain and the other end is placed in the abdominal cavity, chambers of the heart, or space around the lungs where fluid is drained and absorbed by the bloodstream. But an ETV is shown to be more effective (especially over the long-term), with a lower risk of infection and less need for repeat procedures and follow-up than shunting.

No matter what kind of neurosurgical condition or problem your child is facing and regardless of how complex it might be, our top priority is making sure your child receives the best treatment available — whatever it takes.