Children's Hospital Colorado
Orthopedics Institute
Orthopedics Institute

Spine Surgery Quality and Patient Safety Outcomes

ZERO Surgical site infections in our standard spinal fusion patients from 2015-2018
THREE Day average length of hospital stay for our spinal fusion patients
75 Patients admitted to our hospital for spinal fusion surgery in 2018

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 spinal fusion surgery
  • Blood loss estimates: estimated average amount of blood our patients lose during spinal fusion surgery
  • Patient volumes for spinal fusion surgery: number of spinal fusion surgeries our pediatric experts perform each year

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 idiopathic scoliosis. On average, our spinal fusion surgery patients stayed three days at the hospital following surgery.

Average length of hospital stay for spinal fusion surgery

Bar graph showing the average length of hospital stay for spinal fusion surgery reducing from 3.84 in 2014 to 3 in 2017 and 2018.

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 understand that kids who’ve just had spinal fusion surgery are able to 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. 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.

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 2018, and for the third year in row, we had zero surgical site infections in standard risk spine fusion patients. 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 monitor our hospital's compliance with evidence-based practices to help prevent infections.

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 information is reviewed regularly by the spine infection task force to track our progress and how we compare to other hospitals.

Why do we measure estimated blood loss?

We measure estimated blood loss to help manage our patients’ anesthesia needs during surgery. As a patient loses more blood, they need more fluid and medical support. Patients with a large estimated blood loss may also need blood transfusions.

Our surgeons review trends of estimated blood loss 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.

What’s the average estimated blood loss during spine surgery at Children’s Colorado?

The graph below shows the average estimated blood loss patients experience during scoliosis surgery at Children’s Colorado. No patient with adolescent idiopathic scoliosis has required a blood transfusion during surgery since 2015.

Average estimated blood loss for spinal fusion surgery

Bar graph showing the average estimated blood loss for spinal fusion surgery decreasing over time.

What’s the source of this data?

Our anesthesiologists, blood cell salvage technicians and surgeons work together to determine estimated blood loss. We record the information in the patient’s medical record and annually report the averages.

How has the Orthopedics Institute at Children’s Colorado been able to improve estimated blood loss?

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 travel overseas to teach our techniques. We also have published research articles describing the techniques and results.

What are patient volumes for spinal fusion surgery?

Patient volumes include the number of patients who were admitted to a hospital for spinal fusion surgery within one calendar year.

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

Patient volumes for spinal fusion surgery

Bar graph showing patient volumes for spinal fusion surgery remaining mostly flat year over year

Why are spinal fusion surgery volumes important?

Choosing the right surgeon is an important decision. Knowing 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.

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 fusion surgeries higher than other hospitals?

Orthopedic surgeons, nurses and physician assistants at Children's Colorado are specially trained to care just for kids. 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 fusion surgery over other Colorado hospitals.

What is the source of this data?

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

The Colorado Hospital Association 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 Colorado Hospital Association voluntarily submit 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.

Pediatric Health Information System 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.

The Connection Journey: Growing through Scoliosis

It's never easy to learn your child has a serious condition that may require surgery. Jessica and her parents share their spine surgery experience with Emily and her dad as they prepare for her upcoming scoliosis surgery.

Watch their journeys

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