Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

Pathway Background and Objectives

Posterior spinal fusion for adolescent idiopathic scoliosis is associated with significant pain and prolonged hospitalization. Standardizing care for posterior spinal fusion can allow early mobilization, decreased LOS, and minimize opioid related side effects. We also wish to determine if a multimodal analgesia approach improves pain control, as such an approach has helped patients after a “Nuss procedure” (chest repair surgery) use less pain medication and have a quicker recovery postoperatively. The specific objectives of this pathway are to:

  • Standardize inpatient post op care
  • Promote early mobilization
  • Decrease length of stay
  • Minimize opioid related side effects
  • Determine if a multimodal analgesia approach improves pain control

Algorithm  Educational Module

  • Length of time on opioid PCA
  • Gabapentin script written prior to admission for surgery
  • Length of stay (LOS)
    • Overall LOS for all patients
    • Breakdown of LOS by #vertebrae fused
  • Number of post-op infections
  • Length of time from functional clearance until discharge
  • Opioid dose per day in morphine equivalents
  • Number of pain scores above a 6/10 in a 24-hour period
  • Taryn J Hamre, DNP, APRN – Pain and Palliative Medicine
  • William Zempsky, MD – Pain and Palliative Medicine
  • Jeffrey Thomson, MD – Orthopedics
  • Mark Lee, MD – Orthopedics
  • Ana Verissimo, MD – Integrative Medicine
  • Kim Koenig, PT – Physical Therapy

The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case.