Discharge Instructions for Scoliosis Surgery (Pediatric)
DISCHARGE AND AFTERCARE

Discharge Instructions for Scoliosis Surgery (Pediatric)

May 30, 2018

Discharge Instructions for Scoliosis Surgery (Pediatric)

Your child has had surgery for scoliosis. This is a condition where the spine curves and twists from side to side. It is most often found in girls in their early teens. But boys can have it too. No one is sure what causes scoliosis. But it is not caused by things such as carrying heavy bags or playing sports. Scoliosis does tend to run in families (parent, child, siblings). Here's what you need to know about home care after surgery.

Making movement easier

  • Remove throw rugs, electrical cords, and anything else that may cause falls.

  • Use nonslip bath mats, grab bars, a raised toilet seat, and a shower chair in the bathroom.

  • Help your child to use a cane, crutches, a walker, or handrails until his or her balance, flexibility, and strength have improved.

  • Arrange your household to keep the items handy for your child. Keep everything else out of the way.

  • Encourage your child to use a fanny pack, apron, or pockets to carry things and keep his or her hands free.

Activity

  • Encourage naps if your child feels tired. But don’t let him or her stay in bed all day.

  • Make sure your child knows that he or she can't bend at the waist, twist at the waist, or raise hands over the head for the first 2 weeks after surgery.

  • Don’t allow your child to lift anything heavier than 4 pounds for the first 2 weeks after surgery.

  • Keep your child from sitting for longer than 30 to 45 minutes at a time. Frequent short walks are the key to recovery.

  • Encourage your child to sit in chairs with arms. The arms make it easier to stand up or sit down.

Incision care

  • Allow your child to shower as needed, starting 3 days after surgery. Gently pat the incision dry. Don’t rub it or apply creams or lotions.

  • Don’t let your child soak the incision in water (no hot tubs, bathtubs, swimming pools, etc.) until the healthcare provider says it’s OK.

  • Check the incision daily for redness, soreness, or drainage.

Other home care

  • Make sure your child takes his or her medicine exactly as directed.

  • Make sure your child wears his or her back brace as directed by your child's healthcare provider.

  • Don’t give your child nonsteroidal, anti-inflammatory medicines (NSAIDs), such as ibuprofen or naproxen, unless directed by the provider. They may delay or prevent proper fusion of the spine.

Follow-up care

  • Make a follow-up appointment as directed by your healthcare provider.

  • Keep appointments for X-rays. They need to be taken regularly to check the status of your child’s surgery and spinal fusion.

 

When to call your child's healthcare provider

Call the healthcare provider right away if your child has any of the following:

  • Drainage from the incision

  • Redness, swelling, or opening of the incision

  • Increased pain from the incision

  • Fever (see “Fever and children” below)

  • Weakness in the arms or legs

  • Trouble controlling bowels or bladder

  • Painful calf that is warm to the touch and sore with pressure

  • Swelling of their foot, ankle, or calf that is not relieved by raising the feet

  • Chest pain or shortness of breath

  • Increased pain in the back or leg

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider.

  • Armpit (axillary) temperature of 99°F (37.2°C) or higher, or as directed by the provider.

Child age 3 to 36 months:

  • Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider.

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider.

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider.

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

Updated:  

May 30, 2018

Sources:  

2011 The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment Guidelines: Orthopaedic and Rehabilitation Treatment of Idiopathic Scoliosis During Growth. Negrini, S. Scoliosis. 2012;7(3):s1-35.

Reviewed By:  

Bass, Pat F. III, MD, MPH,Joseph, Thomas N., MD