Evidence map›Paper›PMID 42371441›Full record

ArticleCureus2026

Postoperative Pain and Healthcare Utilization Following Chiari Malformation Decompression: A Multicenter Retrospective Cohort Study.

Taylor G Kreul, Tyler D Krall, Susannah Cowley, Scotty Wynn, Mitchel Nelson, Daniel Wieland, Ty Duffy, Kristin Nosova, Mazen Zaher

Abstract read
In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Taylor G KreulPlastic and Reconstructive Surgery, University of Arizona College of Medicine - Phoenix, Phoenix, USA.
Tyler D KrallNeurosurgery, University of Arizona College of Medicine - Phoenix, Phoenix, USA.
Susannah CowleyNeurosurgery, University of Arizona College of Medicine - Phoenix, Phoenix, USA.
Scotty WynnAnesthesia, University of Arizona College of Medicine - Phoenix, Phoenix, USA.
Mitchel NelsonAnesthesia, University of Arizona College of Medicine - Phoenix, Phoenix, USA.
Daniel WielandAnesthesia, University of Arizona College of Medicine - Phoenix, Phoenix, USA.
Ty DuffyAnesthesia, University of Arizona College of Medicine - Phoenix, Phoenix, USA.
Kristin NosovaNeurological Surgery, Banner - University Medical Center Phoenix, Phoenix, USA.
Mazen ZaherNeurological Surgery, Banner - University Medical Center Phoenix, Phoenix, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPostoperative pain following Chiari malformation decompression is frequently severe and may contribute to substantial postoperative healthcare utilization. Although multimodal analgesic strategies are increasingly utilized across surgical specialties, postoperative pain management practices following Chiari decompression remain variable and poorly characterized. This exploratory retrospective study aimed to characterize postoperative analgesic practices and associated healthcare utilization outcomes following Chiari decompression.

methodsA retrospective cohort study was conducted of adult patients undergoing Chiari decompression across four institutions between 2016 and 2023. Postoperative analgesic regimens, including opioid and non-opioid medications, were recorded. Outcomes included postoperative pain scores, length of stay (LOS), postoperative imaging utilization, emergency department (ED) visits within 60 days of surgery, and readmissions.

resultsTwenty-seven patients met inclusion criteria. Postoperative analgesic regimens were heterogeneous, with all patients receiving opioid medications and variable use of non-opioid adjuncts. Eleven patients (40.7%) presented to the ED during the postoperative period, most commonly for headache or pressure-related symptoms. These presentations frequently required additional pharmacologic management and diagnostic imaging, including computed tomography in 63.6% of cases and magnetic resonance imaging in 18.2%. Two patients were subsequently found to have cerebrospinal fluid leaks requiring operative intervention. Exploratory analysis demonstrated lower postoperative day 0 pain scores among patients receiving non-steroidal anti-inflammatory drugs (NSAIDs).

conclusionsPostoperative pain and healthcare utilization following Chiari decompression remain important clinical challenges. In this exploratory retrospective cohort, postoperative analgesic practices were variable, and a substantial proportion of patients required postoperative ED evaluation and additional imaging. These findings highlight the persistent postoperative symptom burden experienced by this patient population and may help inform future prospective evaluation of perioperative pain management pathways and postoperative care strategies following Chiari decompression.

Indexed as

chiari type 1 malformationchiari type 2 malformationenhanced recovery after surgery (eras) protocolsmultimodal analgesiapostoperative pain relief

Identifiers

PMID42371441
PMCPMC13310542

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.