The classics in quality and safety: a review of the top cited pediatric spine quality articles in the last 20 years.

In recent years, a concerted effort has been directed toward optimizing the quality, safety, and value of pediatric spine surgery. This review identifies the most cited articles from the Scoliosis Research Society's Quality and Safety Library and provides a comprehensive review that discusses perioperative management considerations for children with spinal deformities. It addresses pre-, intra-, and postoperative factors crucial for averting complications and optimizing patient outcomes. The review covers articles that advise the pediatric spine surgeon on classification and appropriate selection of fusion levels to accomplish the goals of a balanced, fused spine with retention of functional mobility. It also discusses strategies for infection prevention, neurologic monitoring response, use of enabling technologies, and mitigation of blood loss during scoliosis surgery. Finally, it examines the more recent use of dedicated pediatric spine teams, rapid recovery protocols, and opioid stewardship to enhance efficiency and accelerate recovery following surgery. This comprehensive review serves as a resource for pediatric spine surgeons, encompassing a spectrum of considerations to optimize safety and value in their practice. The collection of highly cited articles collectively contributes to refining surgical strategies, benefitting practitioners at all experience levels in delivering optimal care to pediatric spinal deformity patients.