Defining the associations between weight, obesity and outcomes of posterior fossa decompression for Chiari…

Cohort studyChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery· Jul 2026

Defining the associations between weight, obesity and outcomes of posterior fossa decompression for Chiari malformation in adolescents.

Victor M Lu, Caleigh S Roach, Steven W Hwang

Read paper

Pediatric NeurosurgeryCohort studyPrognosisQ3IF 1.3

Obesity in adolescents is associated with higher odds of major complications after Chiari decompression.

Defining the associations between weight, obesity and outcomes of posterior fossa decompression for Chiari malformation in adolescents.

Victor M Lu … Steven W Hwang

Child's nervous system · Jul 2026 · Q3 in Neurology

Background

Posterior 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.

Purpose

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.

Methods

The 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.

n = 4257 patients

Results

aOR 1.93

obesity roughly doubles the odds of a major complication

n = 4257 patients

More results

A 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 2 , and per CDC definitions 6% were underweight, 51% were healthy weight, 18% were overweight, and 28% were obese (Classes I, II and III).

More results

Overall, median length of stay was 3 days, and rates of 30-day reoperation (any), reoperation (related), unplanned readmission and major complications were 3.0%, 2.4%, 5.4%, and 3.5%, respectively.

“

Conclusion · 1 of 2

In adolescents, there is a clear postoperative profile that exists 30-days after posterior fossa decompression for Chiari malformation based on weight and obesity.

Conclusion · 2 of 2

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.

Defining the associations between weight, obesity and outcomes of posterior fossa decompression for Chiari malformation in adolescents.

Defining the associations between weight, obesity and outcomes of posterior fossa decompression for Chiari malformation in adolescents.

Related papers