Spinal surgery and discharge

What will happen before the operation?

You will be asked to come into the 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, which is a medicine to help you feel less anxious.

A porter, a nurse and one parent will take 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) after your surgery. Once you are comfortable your parents will be able to come to see you. Some children 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 pee, and you may also have an oxygen mask too. There will sometimes be a drain to collect fluid from the wound site. Your wound site will be covered with a dressing.

Getting better

Usually the morning after the surgery, 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 be encouraged to start drinking straight away and then eating a light diet when you feel able. Eventually, 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 children will need to wear a jacket (brace) after 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.

An X-ray will be done a few days after surgery just before you are allowed home.

Most children stay in hospital about 4 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 8 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, ibuprofen or diclofenac, and an opioid medication (Tramadol or Oramorph). Repeat prescription can be obtained from your GP.

Pain relief will need to be taken regularly to begin with, and then gradually wean yourself off over the next few weeks. This will help you be able to comfortably to rest, move around and sleep. We suggest that you stop taking the ibuprofen or diclofenac 2 weeks after discharge.

We also recommend non-medication methods for pain relief including heat, cold, massage, extra pillows and distraction.

Hygiene

Showering may be more comfortable than bathing to begin with and tends to put less strain on the back. You can shower with the dressing on 3 days after the surgery.

You can only take a bath or submerge the wound under water the wound is fully healed (usually 10 to 14 days after surgery).

If your child needs to be lifted, try to give support around the back and under their bottom 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 happen, please inform your GP or the hospital, as this may indicate an infection.

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.

We encourage you to move your back to regain movement in the part of the spine which has not been operated on. Without doing this, a stiff spine may prolong the 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.

After 6 weeks you can do light and non-contact activities, swimming and flying in an aeroplane.

After 3 months you can do gentle exercise such as, gentle running, PE and dancing, badminton, yoga and Pilates.

After 6 months you can do all activities 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.