{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T13:45:39Z","timestamp":1782481539057,"version":"3.54.5"},"reference-count":62,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Chronic and end\u2010of\u2010life pain in children is underreported and undermanaged. Current guidelines for pediatric chronic pain include medical and interventional modalities; however, the inclusion of neurosurgical treatments is uncommon and inconsistent. This systematic review presents the literature, and we provide recommendations for the role of neurosurgical procedures in treating chronic and end\u2010of\u2010life pain in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta\u2010analyses (PRISMA) guidelines using three databases: PubMed, Embase, and Scopus. We included 40 studies presenting neurosurgical procedures for the treatment of chronic and end\u2010of\u2010life pain in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010one (77.5%) manuscripts focused on the treatment of neuropathic pain, five (12.5%) focused on nociceptive pain, and four (10%) treated mixed pain conditions. The most common neurosurgical procedure was intrathecal opioid therapy via pump placement (29.3%), followed by spinal cord stimulation (26.8%). Neuropathic pain syndromes were primarily treated with neurostimulation (58%), demonstrating good efficacy. Ablative procedures (40%) were most effective for nociceptive pain syndromes. Both chordotomy and intrathecal pumps provided subjective pain relief for mixed pain syndromes. The quantification of procedural efficacy, including pain outcomes and grading scales, varied significantly across studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Neurosurgical treatments for chronic pediatric pain are safe, although broad efficacy cannot be determined due to sparse literature and inadequately quantified pain responses. Guidelines for escalating chronic and end\u2010of\u2010life pain management in pediatric patients should be updated to include neurosurgical treatments and appropriate outcome scales. Focused research on appropriate patients, available neurosurgical therapies, and pediatric outcomes is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.70034","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T09:46:30Z","timestamp":1744278390000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Neurosurgical management for chronic and end\u2010of\u2010life pain in children: A systematic review"],"prefix":"10.1111","volume":"25","author":[{"given":"Sunny","family":"Abdelmageed","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurosurgery Ann and Robert H. Lurie Children's Hospital of Chicago  Chicago Illinois USA"},{"name":"Department of Neurosurgery Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0430-2669","authenticated-orcid":false,"given":"Nicole","family":"Villalba","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery Ann and Robert H. Lurie Children's Hospital of Chicago  Chicago Illinois USA"},{"name":"Department of Neurosurgery Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5459-5845","authenticated-orcid":false,"given":"Gloria","family":"Bae","sequence":"additional","affiliation":[{"name":"Chicago Medical School Rosalind Franklin University of Medicine and Science  North Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Mossner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siegfried J.","family":"Adelhoefer","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kannan","family":"Aravagiri","sequence":"additional","affiliation":[{"name":"Division of Pediatric Anesthesiology Ann and Robert H. 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