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Analgesic options for anterior approach to scoliosis repair: a scoping review

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Abstract

Purpose

The ideal analgesic regimen for the anterior approach to scoliosis repair is not clearly defined. The purpose of the study was to summarize and identify gaps in the current literature specific to the anterior approach to scoliosis repair.

Methods

A scoping review was conducted in July 2022 utilizing PubMed, Cochrane, and Scopus databases guided by the PRISMA-ScR framework.

Results

The database search generated 641 possible articles, 13 of which met all inclusion criteria. All articles focused on the effectiveness and safety of regional anesthetic techniques, while a minority also provided both opioid and non-opioid medication frameworks.

Conclusion

Continuous Epidural Analgesia (CEA) is the most well-studied intervention for pain control in anterior scoliosis repair, but other, more novel regional anesthetic techniques offer safe and effective potential alternatives. More research is indicated to compare the effectiveness of different regional techniques and perioperative medication regimens specific to anterior scoliosis repair.

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Data availability

The data obtained during this investigation are available upon request.

References

  1. Weinstein SL, Dolan LA, Spratt KF et al (2003) Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA 289(5):559–567. https://doi.org/10.1001/jama.289.5.559

    Article  PubMed  Google Scholar 

  2. Horne JP, Flannery R, Usman S (2014) Adolescent idiopathic scoliosis: diagnosis and management. Am Fam Physician 89(3):193–198

    PubMed  Google Scholar 

  3. Fletcher ND, Glotzbecker MP, Marks M et al (2017) Development of consensus-based best practice guidelines for postoperative care following posterior spinal fusion for adolescent idiopathic scoliosis. Spine 42(9):E547–E554. https://doi.org/10.1097/brs.0000000000001865

    Article  PubMed  Google Scholar 

  4. Izatt MT, Adam CJ, Verzin EJ et al (2012) CT and radiographic analysis of sagittal profile changes following thoracoscopic anterior scoliosis surgery. Scoliosis 7(1):15. https://doi.org/10.1186/1748-7161-7-15

    Article  PubMed  PubMed Central  Google Scholar 

  5. Izatt MT, Harvey JR, Adam CJ et al (2006) Recovery of pulmonary function following endoscopic anterior scoliosis correction: evaluation at 3, 6, 12, and 24 months after surgery. Spine 31(21):2469–2477. https://doi.org/10.1097/01.brs.0000238659.12918.b5

    Article  PubMed  Google Scholar 

  6. Mathew SE, Hargiss JB, Milbrandt TA et al (2022) Vertebral body tethering compared to posterior spinal fusion for skeletally immature adolescent idiopathic scoliosis patients: preliminary results from a matched case-control study. Spine Deform 10(5):1123–1131. https://doi.org/10.1007/s43390-022-00519-3

    Article  PubMed  Google Scholar 

  7. Seki H, Ideno S, Ishihara T et al (2018) Postoperative pain management in patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis: a narrative review. Scoliosis Spin Disord 13(1):17. https://doi.org/10.1186/s13013-018-0165-z

    Article  Google Scholar 

  8. Chan P, Skaggs DL, Sanders AE et al (2017) Pain is the greatest preoperative concern for patients and parents before posterior spinal fusion for adolescent idiopathic scoliosis. Spine 42(21):E1245–E1250. https://doi.org/10.1097/brs.0000000000002147

    Article  PubMed  Google Scholar 

  9. Tricco AC, Lillie E, Zarin W et al (2018) PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 169(7):467–473. https://doi.org/10.7326/m18-0850

    Article  PubMed  Google Scholar 

  10. Grossetta Nardini HK WLTYMAhmmyeA.

  11. Lowry KJ, Tobias J, Kittle D et al (2001) Postoperative pain control using epidural catheters after anterior spinal fusion for adolescent scoliosis. Spine 26(11):1290–1293. https://doi.org/10.1097/00007632-200106010-00024

    Article  CAS  PubMed  Google Scholar 

  12. Sucato DJ, Duey-Holtz A, Elerson E et al (2005) Postoperative analgesia following surgical correction for adolescent idiopathic scoliosis: a comparison of continuous epidural analgesia and patient-controlled analgesia. Spine 30(2):211–217. https://doi.org/10.1097/01.brs.0000150832.53604.64

    Article  PubMed  Google Scholar 

  13. Blumenthal S, Borgeat A, Nadig M et al (2006) Postoperative analgesia after anterior correction of thoracic scoliosis: a prospective randomized study comparing continuous double epidural catheter technique with intravenous morphine. Spine 31(15):1646–1651. https://doi.org/10.1097/01.brs.0000224174.54622.1b

    Article  PubMed  Google Scholar 

  14. Wenk M, Ertmer C, Weber TP et al (2010) Feasibility and efficacy of preoperative epidural catheter placement for anterior scoliosis surgery. Anesthesiology 113(2):353–359. https://doi.org/10.1097/ALN.0b013e3181e19bb7

    Article  PubMed  Google Scholar 

  15. Chen E, Sites BD, Rubenberg LA et al (2019) Characterizing anesthetic management and perioperative outcomes associated with a novel, fusionless scoliosis surgery in adolescents. Aana J 87(5):404–410

    CAS  PubMed  Google Scholar 

  16. Pandin P, Haentjens L, Salengros JC et al (2009) Combined ultrasound and nerve stimulation-guided thoracic epidural catheter placement for analgesia following anterior spine fusion in scoliosis. Pain Pract 9(3):230–234. https://doi.org/10.1111/j.1533-2500.2009.00275.x

    Article  PubMed  Google Scholar 

  17. Gal JS, Curatolo CJ, Zerillo J et al (2017) Anesthetic considerations for a novel anterior surgical approach to pediatric scoliosis correction. Paediatr Anaesth 27(10):1028–1036. https://doi.org/10.1111/pan.13216

    Article  PubMed  Google Scholar 

  18. Morris SAC, Izatt MT, Adam CJ et al (2013) Postoperative pain relief using intermittent intrapleural analgesia following thoracoscopic anterior correction for progressive adolescent idiopathic scoliosis. Scoliosis. https://doi.org/10.1186/1748-7161-8-18

    Article  PubMed  PubMed Central  Google Scholar 

  19. Mathew S, Milbrandt TA, Potter DD et al (2021) Thoracic paravertebral nerve catheter reduces postoperative opioid use for vertebral body tethering patients. Spine Deform 9(6):1601–1607. https://doi.org/10.1007/s43390-021-00381-9

    Article  PubMed  Google Scholar 

  20. Badawi RI (2005) Interpleural ketamine-ropivacaine mixture compared to thoracic paravertebral block in the management of postoperative pain after thoracoplasty and anterior release of the spine. Egypt J Anaesth 21(3):247–251

    Google Scholar 

  21. Židak D, Židak M, Tudorić-đeno I et al (2018) Efficacy of intercostal block on postoperative pain and analgesic consumption after ventral spondylodesis in scoliosis correction. Acta Med Croat 72(3):307–312

    Google Scholar 

  22. Pineda CL, Poveda LC, Pradilla AP (2021) Case report: Patient controlled analgesia after pediatric scoliosis surgery through erector spinal plane catheter. Revista Chilena de Anestesia 50(4):605–608. https://doi.org/10.25237/REVCHILANESTV50-04-12

    Article  Google Scholar 

  23. Lee NS, Kydes A (2021) Regional anesthetic approaches for postoperative analgesia following vertebral body tethering: a case series. A A Pract 15(8):e01510. https://doi.org/10.1213/xaa.0000000000001510

    Article  PubMed  Google Scholar 

  24. Combo Hiller A, Helenius I, Nurmi E et al (2012) Acetaminophen improves analgesia but does not reduce opioid requirement after major spine surgery in children and adolescents. Spine 37(20):E1225–E1231. https://doi.org/10.1097/BRS.0b013e318263165c

    Article  Google Scholar 

  25. Seki H, Ideno S, Ishihara T et al (2018) Postoperative pain management in patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis: a narrative review. Scoliosis Spinal Disord 13:17. https://doi.org/10.1186/s13013-018-0165-z

    Article  PubMed  PubMed Central  Google Scholar 

  26. Feray S, Lubach J, Joshi GP et al (2022) PROSPECT guidelines for video-assisted thoracoscopic surgery: a systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia 77(3):311–325. https://doi.org/10.1111/anae.15609

    Article  CAS  PubMed  Google Scholar 

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Funding

There were no sources of funding for this investigation.

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Authors and Affiliations

  1. Sidney Kimmel Medical College, Thomas Jefferson University, 833 Chestnut Street, Philadelphia, PA, 19107, USA

    Chris J. Li & John R. Vaile

  2. Department of Anesthesiology, Perioperative & Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA

    Jonathan S. Gal, Chang H. Park & Garrett W. Burnett

Authors
  1. Chris J. Li
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  2. John R. Vaile
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  3. Jonathan S. Gal
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  4. Chang H. Park
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  5. Garrett W. Burnett
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Contributions

CL and JV were involved in project design, data analysis, manuscript composition, revisions, and approval. GB, CP, and JG were involved in design of work, critical revisions, and project approval. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Chris J. Li.

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There are no potential conflicts of interest to disclose. No human subjects or animals were involved in the current study.

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Li, C.J., Vaile, J.R., Gal, J.S. et al. Analgesic options for anterior approach to scoliosis repair: a scoping review. Spine Deform 11, 1031–1040 (2023). https://doi.org/10.1007/s43390-023-00699-6

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  • DOI: https://doi.org/10.1007/s43390-023-00699-6

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