Who Needs a Pediatric Intensive Care Unit After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis?

Haber, Lawrence; Womack, Erika D.; Sathyamoorthy, Madhankumar; Moss, James A; Shrader, M. Wade

doi:10.1016/j.jspd.2017.08.006

Cited by 8 publications

(1 citation statement)

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“…While some centers still require all spinal deformity patients to be transferred to an intensive care unit 37 there is evidence that this is not necessary if appropriate staffing exists. [38][39][40][41] Most centers currently send very few patients with AIS to the PICU and some centers have moved towards only requiring intensive care for select patients with neuromuscular scoliosis. [42][43][44] It is our belief that any patient with a neuromonitoring change intraoperatively, even those that are short and transient, be admitted to the PICU for a minimum of 24 hours of observation.…”

Section: Postoperativementioning

confidence: 99%

Perioperative Blood Pressure Management for Patients Undergoing Spinal Fusion for Pediatric Spinal Deformity

Fletcher¹,

Ghag²,

Hedequist³

et al. 2023

Journal of the Pediatric Orthopaedic Society of North America

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Posterior spinal instrumentation and fusion has become the gold standard for definitive management of children and adolescents with spinal deformity. Despite continued innovations designed to improve the safety profile of this complex surgical undertaking, spinal cord injury and resulting loss of neurologic function remain a rare but devastating risk. The increasing power of instrumentation combined with more aggressive correction strategies puts the spinal cord at particular risk due to traction. While the surgeon has the luxury of complex neuromonitoring techniques to alert the team in the presence of a neurologic change during surgery, maintenance of spinal cord perfusion throughout surgery and in the early postoperative period should be considered to avoid spinal cord ischemia as it accommodates to its new position after deformity correction. This manuscript represents recommendations of the POSNA Quality, Value, and Safety spine committee for optimization of blood pressure in the perioperative period.

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