{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:26:08Z","timestamp":1777591568527,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,1,2]],"date-time":"2013-01-02T00:00:00Z","timestamp":1357084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>It is common practice for patients to be admitted to the intensive care unit following scoliosis surgery, because of the prolonged anesthesia, the need for efficient pain control and the known immediate postoperative complications. However, this may be unnecessary in many patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>We aimed to establish possible associations between pre\u2010 and perioperative parameters and early postoperative complication rates, in particular the need for prolonged mechanical ventilation (&gt;1\u00a0day), and the presence of major complications in children undergoing primary spinal fusion by thoracolumbar spine instrumentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective review of children undergoing primary scoliosis surgery at a university\u2010affiliated general hospital from 1998 to 2008.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Surgical approaches were as follows: anterior spinal fusion, posterior spinal fusion, and combined anterior and posterior fusion. Prior to mid\u20102005, anesthesia included morphine; thereafter, remifentanil was used. Major complications correlated significantly with neuromuscular scoliosis (<jats:styled-content style=\"fixed-case\">NMS<\/jats:styled-content>) (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 4.94; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.02\u201324.05), comorbidity conditions (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 3.47; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.16\u201310.42), and anterior or combined fusion (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 7.81; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 2.12\u201328.57). Late extubation correlated significantly with <jats:styled-content style=\"fixed-case\">NMS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 31.25; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.06\u2013100.00) and morphine use during anesthesia (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 17.91; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.44\u2013222.9).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Relatively young, healthy idiopathic scoliosis children receiving intraoperative remifentanil sedation and undergoing posterior fusion can be successfully managed in regular wards in the immediate postoperative period. However, intensive care unit admission should be considered in <jats:styled-content style=\"fixed-case\">NMS<\/jats:styled-content> patients, patients with comorbidity conditions, those undergoing anterior or combined spinal fusion, and patients whose anesthesia involves long\u2010acting opioids.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12108","type":"journal-article","created":{"date-parts":[[2013,1,2]],"date-time":"2013-01-02T11:06:40Z","timestamp":1357124800000},"page":"271-277","source":"Crossref","is-referenced-by-count":19,"title":["Pediatric scoliosis surgery \u2013 is postoperative intensive care unit admission really necessary?"],"prefix":"10.1111","volume":"23","author":[{"given":"Ibrahim","family":"Abu\u2010Kishk","sequence":"first","affiliation":[{"name":"Pediatric Division Assaf Harofeh Medical Center Zerifin Israel"},{"name":"The Sackler Faculty of Medicine Tel\u2010Aviv University Tel\u2010Aviv 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