Development of Consensus-Based Best Practice Guidelines for Postoperative Care Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

Nicholas D. Fletcher, MD; Michael P. Glotzbecker, MD; Michelle Marks, PT, MA; Peter O. Newton, MD


Spine. 2017;42(9):E547-E554. 

In This Article


Of the initial 25 questions posed via electronic survey, only six reached initial consensus. A group meeting with face-to-face interaction resulted in rewording of questions and group discussion of current practices and expansion to 27 questions. After submitting relevant literature to the group, consensus was gained on 19 statements (Table 1). In addition to the above-listed recommendations that reached consensus, six interventions did not meet consensus (<80% agreement, Table 2). Three questions pertained to timing of specific interventions, including the day for transition of patients from a patient-controlled anesthesia (PCA) pump to oral narcotics, the number of days postoperatively on which hematology labs are collected, and when the Foley catheter is removed. Seventy-one percent of respondents favored transition to oral narcotics from the PCA beginning on the first postoperative day (POD) and 29% on POD#2. Forty-six percent of surgeons obtain postoperative hematology labs for the first postoperative day only, while 46% obtain these labs for the first 2 days. Twenty-four percent of respondents remove the Foley catheter on POD#1, while the remaining 76% do so on POD#2.