Related Experiment Video
Updated: Dec 23, 2025
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Current Trends in Pediatric Spine Deformity Surgery: Multimodal Pain Management and Rapid Recovery
Sagar A Shah1, Richard Guidry1, Abhishek Kumar1
1Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Insights
Multimodal pain management and rapid recovery pathways can significantly improve outcomes for pediatric spine surgery patients. This approach reduces opioid use, pain, and complications, leading to faster recovery.
Area of Science:
- Pediatric Orthopedics
- Pain Management
- Spine Surgery
Background:
- Postoperative pain management in pediatric spine surgery traditionally relies heavily on opioids.
- High opioid consumption is associated with increased risks of side effects and prolonged recovery.
Purpose of the Study:
- To review the literature on opioid alternatives, multimodal pain regimens, and rapid recovery protocols.
- To assess their efficacy in pediatric spine surgery, particularly for adolescent idiopathic scoliosis.
Main Methods:
- A comprehensive literature search was conducted using the PubMed database.
- Studies of all evidence levels were included to provide a broad overview.
- Recommendations were based on the highest level of evidence available.
Main Results:
- Multimodal pain management strategies, combining various analgesics, can effectively reduce opioid consumption and pain.
- Opioid alternatives like NSAIDs, acetaminophen, gabapentin, and regional anesthesia show promise.
- Integrated rapid recovery pathways enhance pain control and expedite patient recovery.
Conclusions:
- A multimodal approach within a rapid recovery pathway offers superior pain management and faster recovery compared to traditional opioid-centric protocols.
- This strategy is particularly beneficial for pediatric scoliosis correction surgery.
Study Design:
Narrative review.
Objectives:
The purpose of this article is to perform a review of the literature assessing the efficacy of opioid alternatives, multimodal pain regimens, and rapid recovery in pediatric spine surgery.
Methods:
A literature search utilizing PubMed database was performed. Relevant studies from all the evidence levels have been included. Recommendations to decrease postoperative pain and expedite recovery after posterior spinal fusion in adolescent idiopathic scoliosis patients have been provided based on results of studies with the highest level of evidence.
Results:
Refining perioperative pain management to lessen opioid consumption with multimodal regimens may be useful to decrease recovery time, pain, and complications. Nonsteroidal anti-inflammatory drugs, acetaminophen, gabapentin, neuraxial blockades, and local anesthesia alone offer benefits for postoperative pain management, but their combination in multimodal regimens and rapid recovery pathways may contribute to faster recovery time, improved pain levels, and lower reduction in total opioid consumption.
Conclusion:
A rapid recovery pathway using the multimodal approach for pediatric scoliosis correction may offer superior postoperative pain management and faster recovery than traditional opioid only pain protocols.
