Background: Few studies addressed the immediate post operative complications after pediatric scoliosis surgery.

Objectives: The objective of this study was to evaluate the influence of pre, intra and post-operative parameters on immediate post-operative course.

Methods: A retrospective review of 109 pediatric patients’ records who underwent spinal fusion & instrumentation for scoliosis in one medical center between 1998–2005. The following data were collected: age and gender; curve type, etiology and degree; pulmonary function tests; surgical approach and the addition of thoracoplasty, operation time; blood products and morphine administration; blood test results at arrival to the intensive care unit (ICU). We evaluated the latter data influence on: 1. Prolonged post-operative ventilatory support. 2. Prolonged duration of ICU hospitalization 3. Presence of serious and non-serious post operative complications. Statistical analysis was done with T-test, Chi-square and Pearson correlations.

Results: Statistically significant correlations were found between neuromuscular etiology and prolonged ICU hospitalization, need for prolonged ventilatory support and the presence of major complications (P< 0.006). Anterior and combined anterior & posterior approaches were found to correlate with higher rate of pulmonary complications(P=0.015). All other parameters were not found to significantly and independently influence the post-operative course.

Conclusions: Anterior and combined approaches as well as neuromuscular etiology were found as risk factors for less favorable early post operative course while the addition of thoracoplasty and use of blood products were not.