Global Spine J 2013;3:7–14.

Adolescent idiopathic scoliosis (IS) is a condition of unclear etiology that occurs in 1 to 3 % of otherwise healthy children and adolescents and when severe can result in respiratory and cardiovascular deterioration.1–3 When the curvature exceeds a certain severity, spinal fusion surgery is indicated, with a goal of correcting the existing curve and preventing further progression while preserving pulmonary function.4,5 However, spinal fusion surgery can result in severe postoper-ative pain,5–7 and when it is the chosen treatment, pain management is a primary concern. The standard of care for pain management for spine surgery in children consists of continuous infusion of intra-venous (IV) morphine supplemented with patient-controlled analgesia (PCA). However, to achieve satisfactory pain control with this method, high doses of opioids must be adminis