Cranio cervical decompression surgery physiotherapy

Why is physiotherapy important after cranio-cervical decompression (CCD) surgery?

Your child will be seen by a physiotherapist after surgery, to help them get back to the mobility they had before, and to check they are moving their neck.

Helping your child after surgery

In the first few days after surgery, children having CCD surgery can feel tired and sick. This can make it difficult to get back to the mobility they had before surgery. Their neck may feel sore and stiff to move because of the surgical wound at the back of their neck.

You can help them by encouraging them to:

• take pain relief as needed
• move in bed, like rolling over and turning their head
• sitting upright in bed (you ask the nurses to help with this)
• sitting in a chair
• walking to the toilet
• using specialist splints and wheelchairs

You do not need to wait until the physiotherapy team comes to see your child to start mobilising, as the nursing team will encourage and support this as well.

Often, children feel dizzy after their surgery, so when they start getting up they should have a healthcare professional or support staff with them.

If your child can use stairs at home, we will practice this with them before they are discharged.

Neck exercises

Children are often reluctant to move their neck after surgery, but this can lead to it becoming stiff and painful.

If your child is reluctant to move their neck, sometimes starting with shoulder rolls and shrugs can help them relax and feel more confident about moving their neck.

These exercises should be done gently and slowly, within a range that is not too painful. The child should be encouraged to do this by themselves. If they are able, they should hold each position at the end of the movement for approx. 10 seconds to give a stretch.

Chin to chest (forward flexion)

Ask your child to look down, and point their chin to their chest.

Looking up (extension)

Ask your child to look up, and point their chin to the sky.

Looking left and right (rotation)

Ask your child to look both sides and try to keep their shoulders and their body still.

Taking ear to shoulder (side flexion)

Ask your child to try to keep your shoulders down and relaxed. Do this on both sides.

For younger children

For younger children, they may need to be built into play:

• parents and carers sitting on different sides of the bed so your child has to turn their head both ways
• place toys or the TV where they have to turn their head to look
• move their favourite toy around so they need to look all over (up and down, over their shoulder)
• games such as I Spy and Simon says

How often should my child do these exercises?

Aim to complete these exercises little and often, at least 3 times a day in the first couple weeks.

It can be helpful to build this into a routine, for example completing them after mealtimes.

Local physiotherapist

If your child needs further physiotherapy, with your consent, we will send a referral to your local paediatric physiotherapy team to follow up after discharge home.

If your child already has a local physiotherapist, we will send them a letter to give them an update about your child’s admission and our input.