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Published on: September 13, 2024
Postoperative Pain and Healthcare Utilization Following Chiari Malformation Decompression: A Multicenter
Taylor G Kreul1, Tyler D Krall2, Susannah Cowley2
1Plastic and Reconstructive Surgery, University of Arizona College of Medicine - Phoenix, Phoenix, USA.
Cureus
|June 29, 2026
Summary
Postoperative pain after Chiari decompression is common and leads to significant healthcare use. Pain management strategies vary, with many patients needing emergency visits and imaging, highlighting a need for better care pathways.
Area of Science:
- Neurosurgery
- Pain Management
- Healthcare Utilization
Background:
- Postoperative pain following Chiari malformation decompression is severe and costly.
- Current pain management practices are inconsistent and understudied.
- This study examines pain management and healthcare use after Chiari decompression.
Purpose of the Study:
- To characterize postoperative analgesic strategies used after Chiari decompression.
- To assess associated healthcare utilization outcomes.
Main Methods:
- Retrospective cohort study of 27 adult patients across 4 institutions (2016-2023).
- Analyzed postoperative analgesic regimens (opioids, non-opioids).
- Assessed pain scores, length of stay, ED visits, imaging, and readmissions.
Main Results:
- Analgesic regimens were heterogeneous; all patients received opioids.
- 40.7% of patients visited the ED post-surgery, often for headache/pressure.
- ED visits frequently led to further imaging (CT/MRI); NSAID use correlated with lower pain scores.
Conclusions:
- Variable pain management and significant healthcare utilization persist after Chiari decompression.
- A notable percentage of patients require ED visits and imaging, indicating ongoing symptom burden.
- Findings support further research into optimized perioperative pain management and care strategies.