Prospective Rod Diameter Prospective Pediatric Kyphosis Study Prospective Study of Deformity Management and Pulmonary Function in Early Onset Scoliosis The Chest Wall and Spine Deformity Registry MRI Analysis of Kyphosis Assessing Outcomes in Children with Neuromuscular Disease Prospective Pediatric Scoliosis Study CT Analysis of Pedicle Screw Placement in Pediatric Patients and Related Quality of Life Issues Treatment of Congenital Idiopathic Clubfoot with the Ponseti Method Past Studies Recent Publications Center for Orthopaedic Research at Columbia University Upcoming Past

Instructions for Scoliosis/Spine Fusion Surgery Patients

These instructions are intended to provide information regarding planning spine surgery and the postoperative care. They address questions most frequently asked by the parents of children who are having surgery.

Pre-Operative Tests and Medication

   

Contact your doctor's office at least 8 weeks prior to the surgery date.  There maybe special test that will need to be done prior to surgery.

Procrit/Epogen

Most of our patients having spine surgery are treated preoperatively with an iron supplement and Procrit/Epogen (Erythropotetin).  The iron supplement starts 6 weeks prior to surgery.  The Procrit is an injectable medication that is administered by your pediatrician once a week for four weeks prior to surgery (see Erythopotetin preoperative treatment for orthopedic surgery)  We need to coordinate this treatment with you pediatrician that is why it is imperative that you contact us as early as possible.

Surgery

• Between 4 PM and 9 PM, on the evening prior to surgery, a nurse form the Ambulatory Surgical Unit will call and let you know when you need to stop eating food and all liquids and what time to arrive at the hospital. Please remember to bring the questionnaire, physical exam report filled out by your pediatrician and the surgical consent form with you to the hospital.
• On the day of surgery, report to the security desk on the first floor of Children's Hospital. You will be directed to the ambulatory surgical unit on the fourth floor. There, a nurse will prepare you for surgery and the anesthesiologist will speak to you.
• Parents may accompany children into the operating room
• After the operation, you will be transferred to the Pediatric Intensive Care Unit (ICU). You will be there for one to two days. There are cots available and one parent may stay overnight in the ICU and on the general pediatric unit.
• Pain medication is administered through a special pump. When you have pain, you will be able to give yourself medication to relieve the pain.
• About two days after surgery, the nurses and physical therapists will begin getting you up and out of bed. Soon you will be walking all around
  the pediatric unit.
  
• The bandage on your back will be changed before you leave the hospital usually you'll be able to take the bandage off 7-10 days after the operation. Often self-absorbing sutures are used so there is no need for "the sutures to be removed". Sometimes staples are used and these need to be removed in a couple of weeks.
• Most patients are able to take a shower (no baths) 7-10 days after the surgery check with your doctor.
  
• Once home you will need to take it easy in terms of activities for 4-6 weeks. Home tutoring will be needed during this time; please contact your school district early regarding this need. The doctor's office will provide you with a letter for the home tutoring.
  
• A follow up appointment with x-rays needs to be scheduled for 6 weeks after surgery. If everything is well, the next follow up appointment will be scheduled for 6 months after surgery.

Call the doctor if

• You develop a fever (>101 degrees)
• Your suture line becomes red, swollen, warm to touch, or if there is drainage from the wound.
• If you have significant pain that is not being controlled by pain medication
• If you experience numbness, tingling or weakness in your legs or feet.
  

Activities

• Activities that twist or rotate the spine need to be avoided during the first 6 months.
• No gym or team sports for up to 6 months after surgery. At the 6 month check up (after surgery) you can discuss with the doctor about increasing your activities.
• Light workout - you may walk on a treadmill or use an exercise bike and participate in a light workout to maintain physical fitness.
• Swimming in a pool or the ocean is allowed, but swimming laps for the first 6 weeks should be avoided.

Spine Fusion with Instrumentation: Post-op Guidelines for Activities

Activity	6 Weeks	6 Months	One Year
School	Return to class
Gym	No gym	Modified PE activities may be prescribed, check with M.D.	Return to activitites after M.D. consult
Swimming	In pool or ocean allowed as soon as wound heals, avoid laps
Lifting 5 to 10 lbs.	No more than 5 to 10 lbs. allowed, consider book bag weight	5 to 10 lbs.	Increase weight
Bicycling	No	Light cycling on level ground	Return to activities after M.D. consult
Light Jogging	No	Check with your M.D.	Resume activities
Driving	Per pre-op ability
Team Sports	Not allowed	Not allowed	No impact sports, i.e. football, hockey, rugby
Amusement Park Rides	Not allowed	Avoid extreme rides.	Per own discretion

Please call us if you have any questions or concerns.

Division of Pediatric Orthopaedics
Morgan Stanley Children's Hospital of New York
3959 Broadway, 8th Floor
New York City 10032
phone 212-305-5475
fax 212-305-8271