Implementation of Virtual Reality for Postoperative Recovery in an Adolescent Idiopathic Scoliosis Population: A...

Introduction: Postoperative recovery following adolescent idiopathic scoliosis (AIS) surgery includes multimodal pain management and physical therapy (PT). Though virtual reality (VR) has been explored as a non-pharmacologic strategy for reducing pain and anxiety during bedside procedures, its impact on postoperative pain and opioid use following AIS correction has not been well characterized.

Adolescent patients undergoing spinal fusion for AIS between March 2024 and June 2025 were eligible for recruitment. Patients completed a 20-min immersive underwater VR scenario prior to each postoperative inpatient PT session. Pain scores (measured on a 10-point Likert scale) before and after PT, opioid usage, number of completed PT sessions, and length of hospitalization were recorded for study subjects and were compared to controls.

Ten patients in the VR cohort were compared to 10 controls. There were no differences in sex (p = 0.58), race (p = 0.07), ethnicity (p > 0.99), or average age at surgery (15.1 vs. 15.8 years, p = 0.30). Patients in the VR cohort had a greater average reduction in pain scores associated with postoperative PT compared to controls (-0.72 vs. +0.61, p = 0.02). Patients in the VR and control groups did not differ significantly with regard to total opioid usage in morphine equivalents (55.7 vs. 49.9 mg, p = 0.71), completed PT sessions (3.2 vs. 3.2 sessions, p > 0.99), or length of hospitalization (2.6 vs. 2.4 days, p = 0.53). Side effects of the VR intervention included fatigue (n = 3), nausea (n = 3), headache (n = 2), eye strain (n = 1), and dizziness (n = 1).

Our pilot study demonstrated that an immersive VR session prior to each postoperative PT session significantly reduced the change in PT-associated pain scores among patients undergoing spinal fusion for AIS. Future investigations utilizing a randomized controlled design will continue to elucidate the impact of VR on postoperative recovery for patients undergoing AIS correction.