P0834 - Isolating the Role of Early Mobilization in Rapid Recovery Protocols for Spine Deformity Surgery

Background/Purpose:
Rapid recovery protocols have gained traction in various surgical specialties including pediatric spine deformity. Previous studies have assessed outcomes after implementation of multiple concurrent interventions. Due to the nature of bundled implementation, previous work has not identified the relative importance of each bundle component. The role of early mobilization has not been established. The purpose of this study was to compare early mobilization to standard mobilization protocols with all other factors remaining constant. We hypothesized that early mobilization would reduce length of hospital stay following surgery for adolescent idiopathic scoliosis (AIS).

Methods:
Patients with AIS who were treated with posterior spinal fusion (PSF) from 2014 to 2019 were retrospectively reviewed. Patients who had neuromuscular or syndromic scoliosis or required a two-staged surgery were excluded. Patients were divided into standard mobilization (SM) and early mobilization (EM) groups. All patients were treated by a single surgeon at a tertiary pediatric hospital. Primary outcomes were length of stay and 30-day readmission rate.

Results:
Ninety-six consecutive patients met inclusion criteria. Patient demographics were similar between groups. Mean length of stay for the SM group was 4.1 days vs. 3.2 days for the early mobilization group (p<.0001). PRN pain medication requirements were similar between groups during the first three days of hospitalization (Day 1, p=0.148; Day 2, p=0.981; Day 3, p=0.2701). There were no readmissions within 30 days of surgery in either group.

Conclusion:
Early mobilization independently led to a decreased length of stay following posterior spinal fusion for AIS. This study demonstrates the value of one component of common rapid recovery protocols while controlling for other peri-operative factors such as diet, nursing, and medication regimens.