Rapid Recovery Pathway for Postoperative Treatment of Adolescent Idiopathic Scoliosis

Postoperative pain protocols play a critical role in recovery and prognosis. Rapid recovery pathway (RRP) is a novel multimodal postoperative analgesic platform with accelerated rehabilitation. METHODS: A retrospective review of 44 patients with adolescent idiopathic scoliosis who underwent posterior spinal fusion between 2014 and 2016 was conducted. Outcomes of a conventional postoperative pain pathway were compared with patients who received RRP postoperatively. RESULTS: RRP patients had shorter length of stay (3.3 vs 4.4 days, P < 0.0001), duration with Foley (1.4 vs 2.3 days, P = 0.01), and fewer days for physical therapy clearance (2.2 vs 3.5 days, P < 0.0001). Overall pain score for RRP patients was lower (1.6 vs 2.9, P = 0.0005). The number of days with patient-controlled analgesia was shorter (1.7 vs 2.6 days, P = 0.002), and daily pain scores were consistently lower in RRP. Overall narcotic use was not significantly different (P = 1). CONCLUSION: Implementation of a standardized RRP with multimodal pain management and early mobilization strategies resulted in reduced daily and overall pain scores, earlier clearance by physical therapy, decreased length of stay, and patient-controlled analgesia usage, but overall no difference in narcotic consumption. LEVEL OF EVIDENCE: Level III, Retrospective Cohort Study