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Length of stay can impact patient-reported outcomes following scoliosis surgery

This study investigates factors influencing hospital stay length after scoliosis surgery, showing longer stays are linked to more spinal segments fused and improved mental health outcomes.

Longer Stays After Scoliosis Surgery Linked to Better Outcomes

Publication Title: Higher postoperative Scoliosis Research Society (SRS) scores and number of levels fused associated with extended length of stay following posterior segmental instrumented fusion for adolescent idiopathic scoliosis

Summary

Question
This study examined factors associated with extended inpatient length of stay (LOS) following posterior segmental instrumented fusion (PSIF), a surgical procedure used to treat adolescent idiopathic scoliosis (AIS). It also investigated whether longer LOS correlates with higher patient-reported outcomes, specifically Scoliosis Research Society (SRS) scores, which measure aspects such as pain, mental health, and satisfaction after surgery.
Why it Matters
Adolescent idiopathic scoliosis (AIS) affects 1% to 3% of children, with some requiring surgical correction to prevent further curvature progression. Extended LOS after PSIF is linked to higher healthcare costs, greater risks of complications, and increased readmission rates. Understanding factors contributing to LOS and their potential impact on patient-reported outcomes could inform strategies to optimize recovery and improve care quality while reducing costs.
Methods

The researchers conducted a retrospective analysis of 118 AIS patients aged 10 to 18 who underwent PSIF between 2020 and 2024 at a single institution. Patient demographic data, surgical details, and pre- and postoperative SRS scores were reviewed. LOS was treated as a continuous variable, and statistical methods were used to identify correlations between LOS, perioperative factors, and SRS patient-reported outcome scores.

Key Findings
The study found that patients who had more than 11 spinal levels fused during surgery experienced significantly longer LOS. Longer LOS was associated with higher postoperative mental health scores in the SRS questionnaire, and trends toward greater satisfaction and improved pain scores were observed, although these did not reach statistical significance. Other factors, such as patient age, sex, ethnicity, curve severity, blood loss, and surgical assistant training level, were not significantly associated with LOS.
Implications
The findings suggest that while minimizing LOS is a priority for reducing healthcare costs and risks, extended LOS may benefit certain patient-reported outcomes, such as mental health. This highlights the need for careful consideration of accelerated discharge protocols, ensuring they do not compromise recovery or overall patient satisfaction.
Next Steps
The authors recommend further prospective research to explore whether accelerated discharge protocols impact patient-reported outcomes negatively. Additional studies could refine definitions of extended LOS and assess their applicability across diverse healthcare systems and patient populations.
Funding Information
This research did not receive any external funding. Yale University also provided funding and support for this research.

Full Citation

Yang A, Seddio A, Tuason D. Higher postoperative Scoliosis Research Society (SRS) scores and number of levels fused associated with extended length of stay following posterior segmental instrumented fusion for adolescent idiopathic scoliosis. Spine Deformity 2025, 1-8. PMID: 41379257, DOI: 10.1007/s43390-025-01250-5.

Authors

  • Dominick Tuason, MD

    Last Author
    Yale School of Medicine

    Assistant Professor of Orthopaedics and Rehabilitation

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