Postoperative dexamethasone administration following posterior spinal fusion for adolescent idiopathic scoliosis: A systematic review of worldwide data.

Background: Dexamethasone reduces postoperative pain and opioid consumption in various surgical populations; however, its role in adolescents undergoing posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) remains unclear Methods: A systematic search of PubMed, Web of Science, Scopus, and Google Scholar was conducted for studies published between 2015 and 2024. Comparative studies evaluating perioperative or postoperative dexamethasone use in AIS patients undergoing PSF were included. Non-AIS populations and noncomparative studies were excluded. Study quality was assessed using the Revised Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale. Results: Four studies involving 614 patients were included. Dexamethasone was associated with reduced postoperative pain, opioid consumption, hospital length of stay, and postoperative nausea and vomiting. No statistically significant difference in surgical site infection (SSI) was observed between dexamethasone-treated and control groups. However, heterogeneity across studies limited quantitative pooling, and available data were likely underpowered to detect small differences in SSI risk. Conclusions: Postoperative dexamethasone administration following posterior spinal fusion for adolescent idiopathic scoliosis appears to improve postoperative recovery parameters, including pain control and opioid reduction. However, current evidence remains inconclusive on surgical site infection risk, and available studies are likely underpowered to detect rare complications.