Spine Surgery Quality and Patient Safety Outcomes

Where is the best place to take a child for spine or back surgery? It’s a tough question that often requires parents to do a lot of research. That’s why we publish our surgery outcomes, or measures of safety and success. It’s information that helps parents learn about why our Spine Program treats more kids, teens and young adults with spine conditions than any other hospital in the Rocky Mountain region. Our spine fusion outcomes information includes:

• Length of hospital stay: average amount of time our patients stay at the hospital to recover after spinal fusion surgery
• Spine surgical site infection rates: how often our patients experience infections related to standard risk spinal fusion surgery
• Need for blood transfusions: the number of blood transfusions we had to perform during standard risk spinal fusion surgery
• Patient volumes for spinal fusion surgery: number of spinal fusion surgeries for adolescent idiopathic scoliosis our pediatric experts perform each year

Spinal fusion surgery hospital stays and recovery time

One of the reasons parents choose our Spine Program for their child's spine surgery is because, on average, our patients experience shorter hospital stays and return to activities more quickly.

The graph below reflects the average length of stay for patients who were treated for adolescent idiopathic scoliosis. On average, our spinal fusion surgery patients stayed three days at the hospital following surgery.

Average length of hospital stay for adolescent idiopathic scoliosis spinal fusion surgery

Why do we measure how long kids stay in the hospital after spinal fusion surgery?

Our spine team uses this information to optimize care before, during and after surgery. The risk of complication increases the longer patients stay in the hospital. Additionally, we know that kids who’ve just had spinal fusion surgery recover better at home where it’s more comfortable. They start to feel better quicker, which may get them back to their regular activities sooner.

How have we shortened hospital stays for kids who receive spinal fusion surgery?

Our team follows care guidelines that are proven to get kids home faster after spine surgery. The guidelines include a specific plan for pain management that helps reduce the amount of prescription narcotic medication patients need and the amount of time they need it. And, under the care of experienced physical therapists, patients can get out of bed to walk shortly after surgery. This approach allows for muscle movement, which decreases stiffness. It also helps patients improve their breathing.

When can my child return to activities and sports after spinal fusion surgery?

Our pediatric spine surgeons use techniques that provide strong fixation of the spine, allowing kids to return to sports and activities sooner. Most patients can resume their normal routine after their first checkup with the spine surgeon, which typically occurs approximately one to two months after surgery.

Patients and families learn what to expect before, during and after the surgery when they attend our pre-surgery spine class. Additional support is available through our nurse line at 720-777-6962.

What is the source of this data?

Our spine team, part of our Orthopedics Institute, tracks the length of each patient's stay for spine surgery. The data is reviewed quarterly and updated on an annual basis.

Spinal fusion surgery infection rates

What is a spine wound infection?

An infection can occur if bacteria enter the surgical wound. This can cause problems in a child’s recovery after spinal fusion, which is why prevention of wound infections after a spinal fusion operation is a top priority for our team.

Parents with kids who have underlying medical conditions may want to discuss infection risk with the surgeon prior to the spine fusion procedure.

Why do we measure spine infections after surgery?

Our spine team is committed to improving outcomes for kids who have spine surgery. A patient who gets this type of infection might have to be readmitted to the hospital, which is why we work so diligently to prevent it.

Monitoring the infection rates in spinal fusion surgeries also helps us investigate what causes the infections.

How many spine surgery site infections have occurred at Children’s Colorado?

In 2023, and for the eighth year in row, we had zero surgical site infections in standard risk spine fusion patients with adolescent idiopathic scoliosis. We monitor patients for infections for 90 days after surgery.

How has the Orthopedics Institute at Children’s Colorado been able to improve standard spine wound infection rates?

In 2007, the Orthopedics Institute started an interdisciplinary spine infection task force to help reduce wound infections. The task force includes spine surgeons, epidemiologists, infection preventionists, pharmacists, anesthesiologists and nurses.

Through this task force, we’ve been able to ensure we're following evidence-based practices to help prevent infections. We are continually improving our surgical techniques to perform surgery faster with less blood loss, which both help reduce infection risk.

What is the source of this data?

This data comes from medical records of patients who have had a spine fusion surgery at the Orthopedics Institute at Children's Colorado. The spine infection task force reviews this information regularly to track our progress and how we compare to other hospitals.

Spinal fusion surgery blood transfusions

Why do we track blood transfusions for spinal surgery?

Children sometimes need a blood transfusion if they lost too much blood during surgery, but we try our best to avoid it. A child who lost enough blood to need a transfusion also likely needed additional anesthesia, fluid and other medical support – all of which we try to minimize. While transfusions are common and safe, there is the possibility of complications, which are typically mild, such as minor allergic reactions and fever. 

Our surgeons review trends of estimated blood loss and transfusions to help understand the success of surgical innovations. We are always striving to reduce blood loss during scoliosis surgery because patients who lose less blood experience quicker recovery times.

How many children needed blood transfusions during standard risk spine surgery at Children’s Colorado?

Since 2015, we have not given a blood transfusion during standard risk spine surgery.

What’s the source of this data?

Our anesthesiologists, blood cell salvage technicians and surgeons work together to determine the need for blood transfusions. We record every transfusion we perform.

How has the Orthopedics Institute been able to reduce the number of blood transfusions during spine surgery?

We use evidence-based guidelines to reduce blood loss during spinal surgery. Specific interventions include:

• Medications
• Surgical tools and techniques
• Experienced surgeons who can safely and effectively perform scoliosis surgery, typically in less than three hours

Our spine team members routinely teach our techniques at national and international meetings for spine surgeons. We also have published numerous peer-reviewed research studies describing our techniques and results.

Spinal surgery patient volumes

What are patient volumes for pediatric spinal surgery?

Greater patient volumes give our surgeons more experience and improve outcomes. Below are the total patient volumes for all spinal surgeries in a calendar year.

Pediatric spine surgery volumes

What are patient volumes for adolescent idiopathic scoliosis spinal surgery?

Patient volumes show the number of patients who were admitted to our hospital for spine surgery for adolescent idiopathic scoliosis within one calendar year.

The graph below highlights the patient volumes for spine surgery at Children's Colorado by year.

Patient volumes for adolescent idiopathic scoliosis spinal surgery

Why are spinal surgery volumes important?

Choosing the right surgeon is an important decision. Knowing about a care team’s experience, training and equipment can help make the decision easier. Research shows that centers and surgeons performing higher volumes of spinal procedures have better outcomes. Greater experience means better results.

Here, our orthopedic spine surgeons treat more kids for spine conditions than any other hospital in the Rocky Mountain region.

Why are our patient volumes for spinal surgeries higher than other hospitals?

Orthopedic surgeons, nurses and physician assistants at Children's Colorado are specially trained to care just for kids and have a wealth of experience. We take time to educate patients and families about their healthcare choices, and we're on the forefront of orthopedic research in the treatment of spine conditions. These are just a few of the many reasons why families choose us for spine surgery over other pediatric hospitals in our region.

What is the source of this data?

Children's Colorado uses information from the Colorado Hospital Association (CHA) and Pediatric Health Information System (PHIS).

The CHA represents 100 hospitals and health systems in Colorado and provides credible information on hospital data and trends to the public. Most of the hospitals in Colorado submit information to the Association as a shared commitment to improving healthcare across the state.

All hospitals in Colorado who are members of the CHA voluntarily submit volumes and length of stay for spine surgery. The information is compiled and made available to the public through the Association’s website. Our team analyzes this data to see how we compare to other hospitals in Colorado.

The PHIS is an organization that collects data from 45 children's hospitals about surgeries and procedures. Our team also analyzes this data to see how our numbers compare to other children's hospitals.