An operation is needed to help straighten your spine, so what happens next?

You will be asked to attend the hospital for a pre-assessment appointment that will be carried out by the Orthopaedic Clinical Nurse Specialist (CNS). This appointment will approximately happen 2-3 week prior to your operation.

• The CNS will ask you and/or your family about your current health and any previous medical or surgical history that may be of relevance.
• You will have a set of observations taken which will include your heart rate, temperature and blood pressure.
• You will require a blood test but a local anaesthetic cream or spray can be used to numb the area to minimise pain.
• Routine swabs from the nose, under arm and groin will be collected to check for the presence of MRSA.
• You will need to provide us with a urine sample during the assessment. All girls over the age of 12 years or those that have start their periods; will require a routine pregnancy test.
• You will have your heart checked with the use of an ECG machine that involves stickers being attached to your chest and limbs which are attached to a machine to monitor your activity, if required by the Consultant.
• You will also be reviewed by the Physiotherapists who will play a large role in your overall care following your operation. The Physiotherapists will teach you exercises in regards to your breathing for and how to roll appropriately after your operation.
• You will have a lung function test this evaluates how well your lungs work.
• Spinal X-rays will be taken of your spine from the front and side whilst bending.
• Medical photos of your back will be taken from different standing and bending positions. These will be repeated 3-6 months’ post-surgery.
• The CNS will discuss with you in depth what will happen on the day you are admitted to hospital for your surgery and the care you will receive after.

Day of admission

Admission to hospital is either late afternoon or early morning of surgery.

• If being admitted on day of surgery you will need to be in the hospital by 6.30am for an 8.00am start.
• It is important that you do not eat or drink anything for a few hours before the anaesthetic. This is called ‘fasting’ or ‘nil by mouth’. Fasting reduces the risk of stomach contents entering the lungs during and after the procedure.
• You will be informed in your pre-assessment of the time that you should be ‘nil by mouth’ – in other words, have nothing to eat or drink before the anaesthetic.
• Once you are settled into your room your nurse will start the admission process. This will involve asking similar questions to those asked at the pre-assessment. Your observations will be checked again.
• A doctor will come to see you to ensure you are fit and healthy for your surgery.
• You will require another blood test in case a blood transfusion is needed during your surgery.
• You will have an anti-microbial wash before surgery.
• You will change into a theatre gown ready for theatre, two people can come with you but once anaesthetised they will be taken back to the ward to wait – or can wait elsewhere if they prefer –but please make sure we have a current mobile phone numbers.
• Spinal surgery takes several hours and following the procedure, you will return to the Paediatric Intensive Care Unit (PICU) or the Flexible Enhanced Recovery Ward bed to ensure you can be closely monitored.

During your stay

Following your surgery, you may spend between 1-2 nights either in the Paediatric Intensive Care Unit (PICU), or the flexible enhanced recovery ward bed to ensure you can be closely monitored.

• Recovery from spinal surgery usually takes between 3 to 5 days.
• Each day, you will be seen by the physiotherapist and other professionals who will help you with your recovery.
• You will need to meet certain goals before discharge, which we will explain.
• It is essential you move once you are able to following surgery and as directed by the physiotherapist.
• You will receive pain relief tailored to your needs. Pain relief is usually given into a vein (intravenously or IV) at the start, changing to medicines taken by mouth (orally) when you feel like eating and drinking again.
• We will check your spinal wound three days after surgery – if it is clean and dry, the antibiotics will be stopped at this point.

During your child’s journey, you and your child will meet various professionals including:

Orthopaedic and Spinal Clinical Nurse Specialist – A specialist nurse who will provide support, advice and information throughout your admission.

Nurses – you will be cared for by a paediatric nurse throughout your admission to the hospital.

RMO – Registered Medical Officer is the doctor providing 24-hour medical cover.

Physiotherapist – a specialist who will teach you breathing exercises and rolling techniques before your surgery and will help you to mobilise after your surgery. They will help you sit, stand and walk around safely and comfortably after your surgery until you are able to go home.

Consultant – your surgeon, who will already know, will carry out your spinal surgery and will be in overall charge of your care.

Play specialist – A specialist who can prepare your child for their operation, provide play activities and provide support the family as a whole.

Discharge Criteria

Before you go home we will need to ensure:

• Your pain is well controlled
• You are eating and drinking
• You are passing urine
• Your wound is dry
• The surgeon is happy with your X-ray
• You are mobilising well: independently getting in and out of bed/chairs and able to walk up and down stairs.

USEFUL NUMBERS REMINDER

Spinal CNS – 0207 580 4400 ext:18049

Mob: 07936363235

Monday to Friday from 8am to 4pm

Out of hours: 0207 580 4400 please ask for PSP (Paediatric Site Practitioner) ext:10843