Postoperative Analgesia After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

Many postoperative analgesic options exist after a posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) with newer interventions gaining attention. It is unclear which provide the most benefit. The aim of this current concept review is to document the efficacy, safety, and the quality of evidence for different methods of pain management after PSF for AIS. Potent analgesia with IV opioids or epidural anesthesia remains the cornerstone of postoperative analgesia following PSF for AIS. A diverse set of analgesic adjuvants are under investigation with promising results, including GABA-analogues, intrathecal anesthesia, nonsteroidal anti-inflammatory drugs, acetaminophen, ketamine, spinal nerve block, alpha-2 agonists, glucocorticoids, and muscle relaxants. Psychiatric interventions and patient education are also proving to provide value. Key Concepts: • IV opioids or epidural infusion are the most widely preferred postoperative pain management strategies following PSF for AIS. • Multimodal analgesic protocols are becoming increasingly common. • Numerous analgesic adjuvants are currently under investigation.