Randomized controlled trials of neurosurgical procedures involving children have been
organized infrequently; as a consequence, the majority of pediatric neurosurgical practice is
not supported by class I data. Furthermore, many trials that have been reported suffer from
serious methodological shortcomings such as insufficient power and poor statistical analysis.
Finally, several trials of neurosurgical techniques that are frequently performed on children
have either excluded children from participation or include an insufficient number of children
to draw strong conclusions. Despite these shortcomings, pediatric neurosurgery, like all
fields in medicine, is gradually moving towards a more stringent evidence-based medicine
standard. This chapter will attempt to summarize the recent progress that has been made in
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