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Spinal surgery and discharge

What will happen before the operation?

You will be asked to come into to hospital the day before your surgery and one of your parents will be able to stay with you overnight. You will be able to eat until 2am and have sips of clear fluid, within reason, until the time of your surgery. You may be prescribed a pre-med, a medicine to help you feel less anxious. A porter, a nurse and one parent will escort you to theatre and your parent can stay until you are asleep. You may be in theatre all day, depending on the type of surgery. Your consultant will advise you.

What does the operation involve?

Every operation is slightly different and will be tailored to your own personal needs. Your surgeon and anaesthetist will discuss this with you at your pre-assessment visit.

Where will I wake up?

You will be transferred to Post Anaesthetic Care Unit (PACU) following your surgery. Once you are comfortable your parents will be able to come to see you. Some patients spend about 24 hours on the Intensive Care or High Dependency Unit before being transferred back to the ward.

What will happen afterwards?

When you wake up you will have a number of ‘drips’ to give you fluids and medication for pain relief. You will have a catheter in your bladder to drain urine and initially an oxygen mask may be needed too. There will sometimes be a drain to collect fluid from the wound site. You may also have a tube through your nose into your stomach which will help prevent you from being sick. Your wound site will be covered with a dressing.

Getting better

After a day of rest you will be allowed to gently sit up and then get out of bed. At first this will feel difficult but the pain relief and assistance from the physiotherapists should help.

You will probably start drinking and then eating again after a couple of days. Gradually the drip, drain and catheter will be taken away and you will be able to take pain relief in medicine form. Soon you will be able to start taking a few steps and then, when you gain confidence, walk around the ward. For children who are wheelchair users, you will be able to sit in your chair for increasing lengths of time.

Your wound site will be checked and a clean dressing applied. Some patients will need to wear a jacket (brace) following surgery. If this is applies to you, your consultant will have mentioned it before unless the need for it could not be predicted. Those wearing a brace before surgery will usually not be required to wear it after surgery.

A check X-ray will be performed a few days after surgery just before you are allowed home. Most children stay in hospital about 6 to 8 days. You will need to provide your own transport home.

When you get home

An appointment will be made for you to come back to the Outpatients department to see your consultant eight weeks after surgery. In the meantime the following information may be helpful:

Pain Relief

You will be given pain relief medications to take home based upon what you have required whilst in hospital. This will usually be paracetamol, a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen or diclofenac, and an opioid medication (Tramadol or Oramorph). Repeat prescription can be obtained from your GP. We suggest that the NSAID is stopped after the first 2 weeks after discharge. Pain relief will need to be taken regularly initially then gradually weaned over a number of weeks to allow you to be comfortable to rest, move around and sleep. Non-medication methods which may also be helpful for pain are heat, cold, massage, extra pillows and distraction.

Hygiene – Showering may be more comfortable than bathing initially and tends to put less strain on the back. It is allowed when the wound has healed, (usually about 5 to 7 days after surgery). If your child needs to be lifted, try to give support around the back and under the buttocks rather than under the arms as this also will cause less strain to the back.

Wound care – Dissolvable stitches are usually used and do not need to be removed. However, after 2 to 3 weeks the suture ends may need to be trimmed. They can easily be snipped, close to the skin, with a pair of sharp scissors that have been boiled in water. If you are not happy to do this your GP Practice Nurse may do it or a District Nurse visit can be arranged. Alternatively you can arrange to come back to hospital to see the Spinal Nurses. The wound must be kept clean. Check for signs of redness, swelling, oozing or pain. If any of these occur please inform your GP or the hospital, as this may indicate an infection. You must not take antibiotics for a wound problem without the wound being seen at the hospital (see contact details).

Getting around – You will be able to move around a little more each day. If you are normally a wheelchair user then you will be able to increase the time spent in it each day. However, it is important to have periods of rest throughout the day as you may tire easily at first. Moving the back to regain movement in the part of the spine which has not been operated on, is encouraged as a stiff spine may prolong pain.

Back to school – Most children return to school between 3 and 6 weeks after surgery but each child is an individual and so this can vary. An option is to go back gradually, for example,  just for half days to start with. You should not carry any more than a light bag and this should ideally be a rucksack. You should lift nothing heavier than a light school bag for at least 3 months after surgery.

Sporting activities –Your Consultant will advise you when you may resume any sporting activities. Do not try to take part in any sports until you have discussed this in clinic but here are some activities often asked about and when you can take part.

  • 6 weeks: light and non-contact activities, swimming and flying in an aeroplane.
  • 3 months: gentle exercise such as, gentle running, PE and dancing, badminton, yoga and pilates
  • 6 months: all activities resumed such as, rugby, football, netball, hockey, theme park rides, skiing, climbing, horse riding, rollerblading, ice skating, gymnastics. All full contact and high impact sports allowed.

If you have any other questions

Feel free to contact the hospital regarding any issue which you feel unsure about. You may find these other resources useful:

Contacts and information

If you have any questions or problems however trivial they may be – please ask.

Spinal Nursing Team
0114 226 7984

Orthotic Department
0114 271 7271

Mr Breakwell, Mr Cole, Mr Athanassacopoulos, Mr Bayley, Miss Srinivas
Secretary 0114 226 7981

Formetric scan advice
0114 226 0602

Ward 2
0114 271 7392 or 0114 2717394

Switchboard 0114 2717000

Scoliosis Association (SAUK)
Helpline: 020 8964 1166
E-mail: sauk@sauk.org.uk
Website: www.sauk.org.uk

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Disclaimer

Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

Resource number: SPN3

Resource Type: Article

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NHS

Western Bank
Sheffield
S10 2TH

United Kingdom

Switchboard: 0114 271 7000

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