Posterior spinal fusion with instrumentation day of surgery
The day of surgery
The morning of surgery it is okay to brush your teeth and rinse out your mouth. Do not swallow the water. Do not chew gum.
When you get to the Stead Family Children’s Hospital, you'll need to check in at the Day of Surgery Admissions (DOSA), take the public elevators to Level 4. The nurse will take your vital signs (temperature, pulse, respiratory rate and blood pressure) and talk briefly with you. You'll get into a hospital gown and the nurses will help you onto a special bed. You will then go back to the EEG lab where they will put the special monitoring wires on your head. Sometimes they will put these wires on in the operating room.
While you are in surgery, your family can wait for you in the Pediatric Surgery Family Lounge (take the public elevators to Level 4). The doctors will talk to them from time to time during your surgery to let them know how you're doing. They will also talk with them after surgery.
A nurse will greet you as you arrive in the operating room. The room is sometimes cool and noisy. Please let the nurses know if you are not comfortable. Warm blankets are available. You will be connected to many monitors in the operating room. This will not hurt. The monitors help the nurses and doctors keep track of how you are doing while you are asleep. An IV will be placed in a vein in your arm or hand. The anesthesiologist will give you medicine in your IV to put you to sleep. A mask may be placed over your nose and mouth to help you breathe.
A tube is placed in the back of your mouth and throat to get air to your lungs while you are asleep. They will put the tube in after you are asleep. This tube is usually taken out before you wake up. Once you are asleep, the doctors will begin the surgery. You will lie on your stomach on the operating bed. Your arms and legs will be supported with pads. Your back will be washed before starting the surgery. The surgery usually takes about 4 hours, but you will be in the operating room a total of 4 to 5 hours.
A tube, called a Foley catheter, is placed in your bladder while you are asleep. The catheter drains urine from your bladder. The nurses will measure your urine and keep track of how well your body is getting rid of the urine. This tube will be removed once you are up walking, typically the day after surgery. You will be able to use the bathroom normally after the catheter is out.
A drain is placed in the incision during surgery. This is called a Hemovac. It is a small tube that drains extra fluid from your back into a small container. The doctors will remove the drain 2 days after surgery. There is a mild burning feeling when the drain is taken out.
Post Anesthesia Care Unit (PACU or Recovery room)
When you wake up you will be lying on your back in the recovery room. You will already be in your hospital bed. You may feel stiff from being in one position for a long time. A nurse will check you often and make you comfortable with warm blankets. You will have oxygen gently blowing in your nose. Your nurse will remind you to cough and deep breathe to exercise your lungs.
The nurse will ask you to rate your pain on a scale of 0 to 10. We will give you pain medicine to make you comfortable. It is not unusual to feel sick to your stomach after surgery. Please let your nurse know if you feel sick. We have medicine for that too.
You will have more x-rays of your back while you are in the recovery room.
You will be in the recovery room for 1-2 hours, or until your doctor and nurse feels you are awake enough to move to your hospital room on the pediatric unit. If you are 16 or younger, your parents or 2 adults can see you while you are in the recovery room.
Some patients will need to go to the Pediatric Intensive Care Unit (PICU) after surgery. PICU is located on level 3 of the Children’s Hospital. This happens if the doctor thinks you should be watched more closely. Your parents can stay with you in the PICU as well. The doctors will decide when you are ready to go to your room on the pediatric unit.
Pediatric unit after surgery
After surgery the nurses will take your vital signs often. This is so important that they will even wake you up at night to do it.
The doctors and nurses will be touching your hands and feet often. They will ask if you have any numbness or sleepy feeling in your arms or legs. Let the nurse or doctor know if your arms or legs tingle, feel numb, or just plain funny.
The medicine used during surgery may cause you to be sick to your stomach. You may even throw up after surgery. The nurses will listen to your stomach every few hours. Your stomach will make noise when it is working again. You may chew gum, which will help your stomach wake up.
You will have pain medicine to keep you comfortable. For the first few days, you'll get this medicine through your IV using the PCA pump. You will get some pain medicine from the pump all the time. You may also have a button you can push if you need extra medicine. Your PCA will continue until your stomach wakes up and you are able to drink and take pain medicine by mouth.
Antibiotics will be given through your IV until your Foley catheter is removed. The antibiotics will decrease the chance of infection.
In the operating room a bandage is applied to your back. This will be removed at home 2 weeks after surgery. The stitches used to close your wound are under your skin. They do not need to be taken out.
For the first 6 hours after surgery you will be flat in bed. After the first 6 hours, the nursing staff will help you move from side to side or sit up in bed. When turning, your shoulders and hips must go all at the same time, like your back is one big log. The nurses will use pillows to keep you comfortable. The day after surgery you get out of bed to chair and walk if you feel up to it. The second day after surgery you will do more walking. A Physical Therapist will help you walk the first time. The Physical Therapist can also help you work on going up and down stairs. You will gradually find it easier to get around.
It is common for girls to start their period after surgery. This may even be your first period.
The nurse or your parents may help you with a bed bath for the first few days. However, it is important that you do as much as you can for yourself. This will keep your arms and legs from getting stiff.
While you are in the hospital your parents will be taught how to take care of you. We’ll encourage you to do as much as you are comfortable doing. Please ask the doctors or nurses any questions you have.
Child Life Specialists help find activities you can enjoy while you are in the hospital. They will come to your room and help you find things to do to pass the time you are in bed. When you can be up and out of your room, you will be invited to attend group activities.