Scoliosis Surgery in Children – What are the Options?

Minimally invasive scoliosis surgery is a procedure to correct an abnormal curving of the spine (scoliosis). Your child may need this surgery if he or she has a severe curving of the spine that has not been helped by other treatments, such as braces.

In the minimally invasive approach, the surgery is done using a thin, lighted scope with a camera on the end (endoscope). This method allows the surgery to be done through small incisions rather than one large incision.

As a result, less time is needed to heal. During the procedure, several bones may be fused together in your child’s back, or metal rods and other surgical hardware may be put in the spine to keep it straight.

Tell a health care provider about:

• Any allergies your child has.
• All medicines your child is taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems your child or family members have had with anesthetic medicines.
• Any blood disorders your child has.
• Any surgeries your child has had.
• Any medical conditions your child has.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Damage to other structures or organs.
• Allergic reactions to medicines or dyes.
• Blood clots.
• Nerve injuries.
• Lung problems.
• Intestinal blockage.
• Scarring.
• Metal rods or devices failing or moving after insertion.

What happens before the procedure?

Staying hydrated

Follow instructions from your child’s health care provider about hydration, which may include:

• Up to 2 hours before the procedure – your child may continue to drink clear liquids, such as water or clear fruit juice.

Eating and drinking restrictions

Follow instructions from your child’s health care provider about eating and drinking, which may include:

• 8 hours before the procedure – have your child stop eating foods.
• 6 hours before the procedure – have your child stop drinking formula or milk.
• 4 hours before the procedure – stop giving your child breast milk.
• 2 hours before the procedure – have your child stop drinking clear liquids.

Medicines

• Ask your child’s health care provider about:
  • Changing or stopping your child’s regular medicines. This is especially important if your child is taking diabetes medicines or blood thinners.
  • Giving medicines such as aspirin and ibuprofen. These medicines can thin your child’s blood. Do not give these medicines unless your child’s health care provider tells you to give them.
  • Giving over-the-counter medicines, vitamins, herbs, and supplements.
• Your child may be given antibiotic medicine to help prevent an infection.

General instructions

• Ask your child’s health care provider how the surgical site will be marked or identified.
• Plan to care for your child for at least 24 hours after you take your child home from the hospital or clinic. This is important.
• Ask your health care provider what steps will be taken to prevent infection. These may include:
  • Removing hair at the surgery site.
  • Washing skin with a germ-killing soap.
  • Taking antibiotic medicine.

What happens during the procedure?

• An IV will be inserted into one of your child’s veins.
• Your child will be given one or more of the following:
  • A medicine to help your child relax (sedative).
  • A medicine to make your child fall asleep (general anesthetic).
• After your child falls asleep, small incisions will be made. The incisions may be made in your child’s back, abdomen, or under the ribs. Several incisions may be needed.
• The endoscope will be placed through one of the incisions. A camera attached to the scope will send images to a TV screen in the operating room.
• Other instruments needed to perform the surgery will be inserted through other incisions.
• Bones in your child’s spine may be fused together.
• Metal rods or surgical hardware may be inserted into your child’s spine.
• Small tubes (drains) may be placed near the incisions to drain extra fluid from the surgical site.
• Stitches (sutures) will be used to close the incisions.
• A bandage (dressing) may be used to cover the incisions.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your child’s blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until he or she leaves the hospital or clinic.
• Your child may have to wear a hard plastic brace.
• Your child may be given medicine for pain.
• Your child may need to take fluids, medicines, or food through an IV.

Summary

• Minimally invasive scoliosis surgery is a procedure to correct an abnormal curving of the spine (scoliosis).
• Scoliosis surgery may be needed to correct severe curving of your child’s spine.
• Surgery may be done to fuse several bones together or to insert metal rods and other surgical hardware.
• After the procedure, your child may have to wear a hard plastic brace.