ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2026
Defining the associations between weight, obesity and outcomes of posterior fossa decompression for Chiari malformation in adolescents.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 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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Abstract
backgroundPosterior fossa decompression in the setting of Chiari malformation is a common neurosurgical procedure in adolescents; however, the effect of obesity on its surgical outcomes is understudied. This is partly due to the lower incidence of obesity in adolescents requiring higher statistical power. Correspondingly, we sought to interrogate a national surgical database to aggregate a significant cohort size to elucidate possible relationships between obesity and surgical outcomes in this niche.
methodsThe American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-Pediatric) database from 2015-2024 was interrogated against selection criteria targeting patients aged 10-18 years old surgically treated for Chiari malformation type 1. Adolescent weight was defined by body mass index into categories according to the definitions by Centers for Disease Control and Prevention (CDC). Thirty-day surgical outcomes were modeled using a multivariate logistic regression controlling for covariates across a primary model, and then across various sensitivity models.
resultsA total of 4257 patients satisfied selection criteria with a median age of 14.4 years, 65% female and 35% male. Median BMI was 22.7 kg/m
conclusionIn adolescents, there is a clear postoperative profile that exists 30-days after posterior fossa decompression for Chiari malformation based on weight and obesity. This profile is defined by increased morbidity rather than mortality, and future studies are needed to determine how these findings can be effectively integrated into preoperative evaluation and prehabilitation workup for patients to optimize surgical outcomes further.
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