{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:22:27Z","timestamp":1787764947064,"version":"build-2784847793"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Chiari malformation (CM) is a cluster of related developmental anomalies of the posterior fossa ranging from asymptomatic to fatal. Cranial and spinal decompression can help alleviate symptoms of increased cerebrospinal fluid pressure and correct spinal deformity. As surgical intervention for CM increases in frequency, understanding predictors of reoperation may help optimize neurosurgical planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This was a retrospective analysis of the prospectively collected Healthcare Cost and Utilization Project\u2019s California State Inpatient Database years 2004\u20132011. Chiari malformation Types 1\u20134 (queried with ICD-9 CM codes) with associated spinal pathologies undergoing stand-alone spinal decompression (queried with ICD-9 CM procedure codes) were included. Cranial decompressions were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      One thousand four hundred and forty-six patients (29.28 years, 55.6% of females) were included. Fifty-eight patients (4.01%) required reoperation (67 reoperations). Patients aged 40\u201350 years had the most reoperations (11); however, patients aged 15\u201320 years had a significantly higher reoperation rate than all other groups (15.5% vs. 8.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.048). Female gender was significantly associated with reoperation (67.2% vs. 55.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.006). Medical comorbidities associated with reoperation included chronic lung disease (19% vs. 6.9%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), iron deficiency anemia (10.3% vs. 4.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.024), and renal failure (3.4% vs. 0.9%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.05). Associated significant cluster anomalies included spina bifida (48.3% vs. 34.8%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.035), tethered cord syndrome (6.9% vs. 2.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.015), syringomyelia (12.1% vs. 5.9%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.054), hydrocephalus (37.9% vs. 17.7%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), scoliosis (13.8% vs. 6.4%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.028), and ventricular septal defect (6.9% vs. 2.3%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.026).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Multiple medical and CM-specific comorbidities were associated with reoperation. Addressing them, where possible, may aid in improving CM surgery outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_140_23","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:45Z","timestamp":1701216045000},"page":"336-340","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of reoperation for spinal disorders in Chiari malformation patients with prior surgical decompression"],"prefix":"10.4103","volume":"14","author":[{"given":"Oluwatobi O.","family":"Onafowokan","sequence":"first","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankita","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamshaid M.","family":"Mir","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haddy","family":"Alas","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler K.","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Mcfarland","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Varghese","sequence":"additional","affiliation":[{"name":"Twin Cities Spine Centre, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Naessig","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bailey","family":"Imbo","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Passfall","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Krol","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Tretiakov","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Joujon-Roche","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Dave","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York, 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