Spinal Fusion for the Treatment of Idiopathic Scoliosis in Children: Orthopedic Surgery to Treat Curvature of the Back in Children and Teenagers
Edited By: Kit M. Song, M.D.
Last updated Thursday, October 20, 2005
Recovering from surgeryPain and pain management Scoliosis and spine surgery can be quite painful. In major
medical centers where spinal fusions are performed on a regular basis, there is
often a pain service with specially trained staff to help manage the patient’s
pain after surgery. Intravenous use of medications, such as morphine, are used.
This is often given with a patient controlled analgesic (PCA) which is a pump
with a push button allowing for more rapid delivery of medication when
necessary. Typically, intravenous pain medication is used for three to four
days after the procedure. The patient usually transitions to oral medication by
day four or five. Patients are then
discharged from the hospital on oral pain medication. More recently, epidural catheters have been
left in the space adjacent to the spinal cord and pain medications are
delivered directly to the spine for a few days before transitioning to oral
pain medications.
Pain medication will generally be
needed for two to three weeks after discharge from the hospital. The pain is
usually managed well with oral medications by the time the patient leaves the
hospital. At this time, they are also able to move about without much
limitation. Effectiveness of medications Nausea and vomiting are common
when taking pain medication.
Additionally, constipation can be a significant problem and may require
stool softeners or other medication to help with bowel movements. Sedation and
sleepiness after pain medication is also common.
Hospital stay The typical course of recovery
after spinal fusion is for the patient to sit on the edge of the bed the first
day after surgery. By the second day after surgery, the patient is up and
walking in the room and later in the hallway. Pain medications are given by IV
for three to four days after surgery. A liquid diet is started shortly after
surgery and is advanced rapidly to a regular food program.
X-rays are taken with the patient
in an upright position three to four days after surgery to make sure the spinal
instrumentation is in the same place it was left at the end of surgery. On
average, the length of stay is about four to five days in the hospital. Recovery and rehabilitation in the hospital A physical therapist will
initially assist the patient in getting out of bed. Following that, the goal is to have the
patient move independently and to be able to get out of bed with only minimal
assistance by the time they are discharged.
Most patients are extremely tired
and fatigued for about three to four weeks after the operation. This is because
the body requires a large amount of energy to heal from surgery like this and
because blood counts are low due to blood loss during surgery. By four or five
weeks after the surgery, most patients are feeling pretty well and by six
weeks, frequently parents must slow their children down to avoid a too rapid
return to full activity. Hospital discharge Generally, patients will be
restricted from sport activities and heavy lifting for at least six weeks.
After six weeks, patients are allowed to do a little bit of light swimming. The
weight limitation for lifting is about 10 to 15 pounds. School-age patients
will typically miss about four weeks of school.
Parents are advised to secure an extra set of books at school so
patients do not have to carry a heavy backpack to and from classes and to
arrange for children to be released from class a few minutes early to avoid the
rush in the hallways.
After three months, patients may
return to light sports. This includes running on level ground, swimming and
riding a bicycle.
After six months, they can return
to full activity. Convalescent assistance Patients can go home following
spinal fusion for idiopathic scoliosis and they do not require a convalescent
facility. They will need some help from their family members to move up and
down stairs and to walk until they can do so without assistance.
All rehabilitation can be
completed at home and does not require special expertise. The goal in the first
four to six weeks after surgery is simply to increase the distance of walking
each day. Surgery for Idiopathic Scoliosis at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 (outside the Seattle area: 800-440-3280) to make an appointment.
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