Is Your Child is Having Spinal Surgery at COA?
If your physician has recommended spinal fusion surgery for your child’s scoliosis, there is a lot of information to take in. Below is a brief summary of what to expect with your surgical experience with Children's Orthopedics of Atlanta.
Where will the surgery take place?
The majority of spine surgeries are performed at the Children’s Healthcare of Atlanta’s Scottish Rite campus. The advantage of having surgery at this facility is that your child is surrounded by an experienced team of doctors, nurses, and other support staff, that take care of children with spine surgery time and time again.
Spinal Surgery FAQs
How is the spinal surgery performed?
Scoliosis surgery, or a spinal fusion, is used to prevent the curve from progressing. Your Children's Ortho spinal surgeon will often insert metal screws attached to rods to hold the spine in place. Spinal technology has advanced greatly in the past 20 years. Not only do our surgeons fuse the spine, but we provide a great deal of curve correction during the surgery. An incision is typically made in the middle of the back over the area where the fusion is required. Scars from a spinal fusion usually heal very well and fade with time, but they will always be present.
What types of safety precautions do the surgeons use during the procedure?
Our surgeons at COA use advanced equipment during the surgery, such as robotic-assisted or real-time navigation equipment, to improve safety and accuracy of hardware placement. There are many other precautions that are taken during surgery to decrease potential risks, including both cell saver and neurological monitoring.
Cell saver is a technology in which the blood that is incidentally lost during surgery is collected in a special container. The blood is then cleaned and filtered and is able to be transfused back. Although not all the blood loss is salvageable, the use of cell saver significantly decreases the risk for the need of a blood transfusion from another person.
Neurological monitoring is utilized in all scoliosis surgeries. Once your child is asleep, a number of small needles are inserted in certain muscles throughout the body. This allows the technologist to monitor your child’s spinal cord and nerve function during the surgery. If there are any changes that are detected, it warns your surgeon and anesthesiologist, and most issues are able to be easily corrected.
How should I prepare my child for surgery?
The Children's Ortho doctors always send you home with a packet full of information about your child's surgery. Your child will have a pre-admission visit with anesthesia prior to surgery. Blood work may be drawn at that time along with an interview with the anesthesia team. In addition, your surgeon may request that a CT scan of the spine be performed prior to surgery. This imaging study helps your doctor plan for the surgery and allows him/her to use the robot or virtual navigation at the time of surgery. While at the pre-operative visit, you will also receive some chlorhexadine wipes to start cleaning your child’s back prior to surgery. This will help sterilize the skin prior to surgery.
What can we expect the day of surgery?
Be sure to come to the pre-operative area at least two hours prior to your scheduled surgery time. On the morning of surgery, you and your child will meet a lot of different people. This will include members from the anesthesia team, the nursing staff in the pre-operative area as well as the nurse that will be in the operating room with your child. The technician that will be monitoring your child's spinal cord and the orthopaedic surgery resident or fellow that will be assisting your surgeon will also speak with you in the morning. Your child will receive medication to help him or her relax prior to surgery but will not go to sleep until back in the operating room.
How often will I get updates on my child while they are in operation?
While your child is in the operating room, the OR nurse will call and give you an update on your child's surgery approximately once every hour.
What happens after surgery?
After the surgery, your child is in the recovery room approximately 60-90 minutes. Unfortunately, you will not be able to see your child in the recovery room because of privacy issues. Once out of recovery, we will direct you to the room your child will be in and you can wait there until their arrival.
The Hospital Experience
One or both parents are permitted and encouraged to stay with your child during the hospitalization, including the nighttime. On the night of surgery, your child’s nurse will be very attentive, turning your child every few hours and ensuring that he or she is as comfortable as possible. Your child will wake up with a catheter in his/her bladder.
Pain medication initially is with morphine through an IV. Your child will have a button to help administer the morphine through a system known as a PCA (patient controlled analgesia).
Physical therapists will help your child get out of bed – this begins the day of surgery or the following day.
Expectations Post Spinal Fusion Surgery
Every day, your child will make different progresses. The first day after surgery, the morphine PCA machine is typically removed and the catheter in the bladder is removed. Pain medication is then administered by mouth and also through an IV shot as needed. Your child’s endurance will begin to improve and he/she will be able to walk around the hallways a little bit easier. Lastly, with regards to diet, at first, your child will only be allowed to have some ice chips and drink clear liquids. Soon, the diet will be advanced once signs of hunger return. Keep in mind that it may take weeks for a normal appetite to return.
When can we go home?
Your child will typically stay in the hospital for three to four days. There are several things that your surgeon is looking for before allowing your child to go home:
- Pain – pain has to be manageable with just pill medications.
- Diet – your child has to be able to keep at least some liquids down without any nausea and or vomiting.
- Walking – your child will be working with a physical therapist. The last “challenge” with physical therapy is to be able to climb up and down several stairs. Your child needs to pass physical therapy prior to discharge.
Still have questions? Please don't hesitate to call or contact us with any further questions regarding your surgery.