Was this information helpful?

(optional)
(optional)
 Security code

 

Thoracoscopic Scoliosis Surgery

Welcome

At Mater Private Hospital Brisbane, we acknowledge that having an operation can be a very stressful experience. This booklet aims to alleviate some of your concerns, in keeping with our Mission to offer compassionate, quality care that promotes dignity while responding to patients’ needs. It explains the general day-to-day events that may occur during your visit and the things to expect when you are discharged from the hospital.

It is, however, only a guideline as each person may require differing treatments.

If you have any questions about your treatment please ask your doctor or nurse. Our pastoral care team also offers a caring support network to all patients regardless of religion. The dedicated members of this team are available at your request.

What is Thoracoscopic Scoliosis Surgery (keyhole surgery)?

Most commonly this technique is offered to younger patients, mostly teenagers, who have a scoliosis curve of around 40 degrees or more in the thoracic spine. The surgery is performed under a special anaesthetic that permits one of the lungs to be deflated to expose the spine inside the chest cavity. Special keyhole telescopic instruments allow the doctor to enter the chest cavity and work on the section of spine that makes up the scoliosis.

A single screw is placed into each vertebra bone through three or four portal holes, 2cm long, in the side wall of the chest. The patient needs to be asleep on their side for the duration of the surgery, which will be four to five hours.

There is usually no need for a brace after surgery.

A titanium metal rod and screws are placed into the vertebrae (usually six or seven screws) and the curve corrected. It is not possible to fully straighten the spine. Bone graft from the bone bank is placed in the discs between the screws.

  1. 3D CT Reconstruction of Idiopathic scoliosis
  2. Preoperative X-ray of right thoracic scoliosis
  3. Postoperative X-ray of same patient after Thoracoscopic Rod for scoliosis correction

During your consultation with Dr Askin you and your child should have:

  • received a detailed operation plan
  • had opportunity to ask any questions regarding the surgery
  • signed consent forms for your surgery.

Return to Activity Table

The following table is a guide to when your child may recommence various activities following their surgery.

Activity 1–2 weeks 8 weeks 3 months 6–9 months

Shower

Yes

     

Walking

Yes

     

Passenger in car

Yes

     

Sit in swim pool (no stroking)

2 weeks

     

School

No

3 weeks

   

Lifting up to 7 kg

No

Yes

   

Light arm exercises

No

Yes

   

Pilates session

No

Yes

   

Stationary exercise bike

No

Yes

   

Swimming in pool—no diving

No

Yes

   

Drive prolonged period eg. > 1 hour

No

Yes

   

Carry heavy school bag (approx 10kg)

No

No

Yes

 

Bicycling

No

No

Yes

 

Light jogging

No

No

Yes

 

Ten pin bowling

No

No

No

Yes

Non contact sports

No

No

No

Yes

Routine PE class

No

No

No

Yes

Running

No

No

No

Yes

Swimming in surf

No

No

No

Yes

Skiing

No

No

No

Yes

Diving

No

No

No

Yes

Bowling (cricket)

No

No

No

Yes

Tennis or golf

No

No

No

Yes

Lifting > 20 kg

No

No

No

Yes

Gymnastics

No

No

No

Yes

Horse riding but no jumps

No

No

No

Yes

Amusement park and playground equipment

No

No

No

Yes

Contact sports

No

No

No

Yes

Rollerblading or skating

No

No

No

Yes

Rowing machine

No

No

No

Yes

 

Admission to hospital

What to bring

  • pyjamas, clothes that are front opening (for easier dressing)
  • toiletries (including toothbrush, toothpaste, hairbrush)
  • comforters (such as blankets, teddy bears, pillow)
  • your child’s regular medications
  • relevant medical information
  • sanitary pads or tampons (if necessary)
  • special dietary requirements
  • electrolyte drinks such as Gatorade.

When you come to hospital proceed to the reception desk on Level 6 at Mater Private Hospital. You will then be directed to the patient care unit.

On admission the staff will show you to your child’s room. The admitting nurse will introduce themself, show you around the ward, and explain the available facilities. If you wish to remain with your child, one parent/carer may stay overnight, and a fold-out bed or recliner chair will be provided. Please discuss this with your nurse.

The admitting nurse will apply an identification band to your child’s wrist or ankle, which will stay on for the duration of their stay for identification and safety reasons. If the identification band falls off or is pulled off, please notify nursing staff as a new one will need to be applied.

The admitting nurse will ask about your child’s medical/surgical history and any particular needs they may have while in hospital. It is important to provide the staff with detailed and accurate information, so that they can properly plan to meet your child’s needs.

Please advise the nursing staff if you have not seen a physiotherapist pre-operatively or if your child:

  • is feeling unwell
  • has an ear infection
  • has a cough or cold
  • is vomiting
  • has diarrhoea
  • has a fever
  • has had contact with any infectious illnesses (such as chicken pox)
  • has any scratches or broken skin (including acne).

If you think your child has any of the above conditions, please notify the hospital prior to admission by phoning Dr Askin’s rooms on 07 3010 3324, from 8.30 am to 5 pm, Monday to Friday. Outside of these hours, please telephone 07 3163 8111 and ask for the Mater Private Hospital nurse manager.

Your child will be weighed on admission and vital signs (temperature, pulse, respiratory rate, blood pressure) will be recorded. Your child can expect to stay in hospital for four to seven days or until they meet the expected recovery outcomes. Please ask your child’s nurse to discuss these with you.

Your child may require the following tests:

  • blood tests
  • urine test
  • electro cardiogram (ECG)
  • pulmonary function test
  • CT scan
  • chest X-ray
  • spinal X-rays (if applicable).

You and your child may be seen by the anaesthetist and doctor in the ward. It is important to tell your child’s doctor, anaesthetist or admitting nurse, if they are taking any medicines, including herbal or homeopathic tonics.

You and your child may be taken through the Intensive Care Unit (ICU) to become familiar with the area. Equipment and noises in the ICU may cause anxiety for you and/or your child. Please inform the nurse if you do not wish to visit this area.

All children having spinal surgery are admitted to the ICU following surgery, where they are closely monitored for a minimum of one night.

Please discuss the following with your child’s nurse:

  • your plans for staying with your child while they are in hospital
  • your child’s medical condition/s and any previous operations they have had
  • the expected recovery outcomes for spinal surgery
  • your child’s regular medicines, including herbal or homeopathic tonics
  • any allergies or reactions to medicines, tapes or foods
  • what the nursing staff need to know to make your child as comfortable possible
  • fasting instructions before the operation
  • your child’s experience of pain
  • your child’s bowel routine (if applicable)
  • pre-surgery physiotherapist appointment
  • visiting the ICU before the operation
  • whether you’d like your child to be visited by hospital volunteers.

Before the surgery

On the morning of surgery, your child will have a bath/shower where their hair will be washed with an antibacterial wash. If your child is allergic to iodine or soap, please inform the nurse. Your child will be asked to wear a hospital gown. Long hair should be plaited (no metal hair bands please).

Your child will fast from midnight, in preparation for surgery the following day. They cannot have anything to drink or eat (including chewing gum and lollies) before the operation.

We understand that this may be a very difficult time for your family. Please discuss any concerns that you may have with your nurse to make the following days as comfortable as possible for your family.

The anaesthetist may have requested a particular medicine be given to your child before the operation, which could cause drowsiness.

Your child should remain on their bed and be supervised at all times. We advise you to take your child to the toilet before taking the medicine or before they are taken to the operating room.

When it is time for your child to have their operation, they will be transported to the Operating Room Reception in a bed accompanied by you and the nurse. The nurse will check that your child’s identification band is correct and ask you questions relating to the operation.

Whilst your child is in the Operating Room you may like wait in your child’s room or in the waiting area. If you have requested to speak with the surgeon immediately following the surgery please advise the staff where you will be waiting.

After the surgery

After your child’s operation, they will be transferred to the ICU and a nurse will call you when it is possible for you to see your child. It can be distressing to see your child after their operation—they may be sleeping, crying or be quietly awake. Your presence will be important as they will need to see a familiar, caring face. Often children will begin to cry when they see you.

The anaesthetist may recommend your child remain asleep for a longer period, in which case they will require a breathing tube. They may also be attached to:

  • monitoring equipment
  • intravenous therapy (a drip)
  • intravenous therapy with strong pain medicine (such as morphine)
  • a urinary catheter
  • a chest drain
  • large dressing covering their wound.

The nurse will be monitoring your child regularly, including temperature, pulse,respiratory rate, blood pressure and regular assessment of intravenous therapy, pain management, dressing, circulation and movement, and level of comfort. Blood tests will be performed routinely in the post operative period.

When your child is fully awake after the surgery they are able to have clear drinks (such as Gastrolyte), cordial, soup and orange juice.

Your child will be nursed flat on their back for the first six hours following the surgery. After this time, your child will be turned from side-to-side, as comfort permits.

A physiotherapist will be involved in the care of your child while they are in ICU. Your child’s physiotherapist will assist with breathing and circulation exercises and bed mobility as necessary.

Post-operative phase

Your child will be transferred to their ward the day after surgery, following a review from the team of doctors who performed the surgery.

The ICU nurse will discuss your child’s operation and post surgery instruction with the ward nurse and take a full assessment of your child’s health. It is routine that a nurse will monitor your child regularly in the post-operative phase.

Every day that your child is in hospital, the team of doctors that operated on your child, will see them to make sure they are recovering. If there are any concerns with your child, a nurse will speak with the doctors.

A physiotherapist will visit your child each day to assist with:

  • deep breathing exercises and activities
  • routine circulation exercises while your child is resting
  • moving about in bed while taking care of the spine
  • getting in and out of bed correctly
  • exercises to strengthen tummy muscles and new posture
  • walking and stair climbing
  • providing your child with a home program comprising walking and exercises to strengthen the spine and improve posture.

It is important that your child’s pain is controlled and that they are comfortable. In the first two to four days after the operation, your child will be having strong pain medicine (received through intravenous therapy). There will also be local anaesthetic pumped into the chest cavity to assist with pain relief for the first 48 hours. Other pain relieving medicines may also be given orally. The nurse will be assessing your child’s comfort and pain by using a pain assessment scale (this will be discussed with you and your child before the surgery or immediately after).You will be actively involved in helping the nurses understand your child’s pain. It is very important to inform the nurse when your child is experiencing pain.

It is not uncommon for your child to feel sick after the anaesthetic, and in the first few days following the operation. Please inform your nurse if your child is vomiting and if you feel they are feeling unwell. If this becomes a persistent problem, medicine may need to be administered or altered.

When your child is fully awake after the surgery, they may have clear drinks only. Their normal diet may commence gradually when they are tolerating these fluids. Your child will have intravenous therapy for two to three days after the operation or until they are able to tolerate diet and fluids. Please ask the nurse before giving your child anything to drink or eat, as they will be recording the amounts that your child is drinking and eating.

For children who have a urinary catheter, this will be taken out by nursing staff when the doctor advises (usually two or three days after surgery). There will be a chest drain (tube) to allow fluid/blood to drain from the chest cavity (usually removed two days after surgery).

The dressing on your child’s back will be changed at the time that the chest drain is removed, usually on the second day after surgery. A waterproof dressing will be applied which will allow your child to bathe.

The nurse will be recording the amount of urine that your child is passing and when they have a bowel motion. After the operation, your child may not have a bowel motion for a few days. This may be because your child is not consuming their normal diet and/or the pain medicines are causing constipation. It may be necessary for your child to have an enema if they become constipated. Your child’s usual bowel medicines and routine should be discussed with the nurse before the operation so as to avoid any problems after the operation.

Your child will have a sponge bath daily until the dressing has been changed and your child is able to shower. Daily care routines will continue.

Early menstruation or break-through bleeding may occur in female adolescents following surgery. This is not unusual after a major operation.

Your child may have an X-ray before discharge.

Discharge phase

Your child will be ready to go home when the treating doctor considers them ready for discharge, and when they:

  • are walking freely and independently
  • are tolerating a well-balanced diet
  • are able to tolerate daily activities
  • have effective control of pain with oral analgesia (tablets/medicine)
  • have wound healing without complications.

Seek medical help if

  • your child has a fever, chills, redness, warmth or foul smelling drainage at the wound site
  • your child experiences an increase in pain
  • you have any questions or concerns.

Scoliosis information websites

These websites contain useful and interesting information about scoliosis and its treatment:

Contacts

  • Queensland Ambulance Service 000
  • Mater Emergency Care Centre

For more information, contact:

Mater Private Hospital Brisbane
Reception: 07 3163 2590

Mater Private Hospital Brisbane

The largest of Mater Health Services’ private facilities, Mater Private Hospital Brisbane is a flagship for the level of care and facilities our organisation strives to provide. The tertiary, acute facility is built on a foundation of clinical excellence and a commitment to safe, compassionate care, that is:

  • quality focused
  • technologically advanced
  • customised to patients’ needs and lifestyle.

Mater Private Hospital Brisbane is an outstanding health care provider with a total of 323 patient beds, 10 operating theatres, a 24-hour private emergency service, preadmission clinic, CardioVascular Unit, Intensive Care and Coronary Care Units, Breast Cancer Centre and Day Procedure Unit.

All rooms and facilities are designed to offer comfort and privacy, complete with a range of modern, air-conditioned accommodation.

While in hospital, patients also have access to allied health (dietitians, physiotherapists,etc.), pharmacy, hairdressing and chaplaincy services.

For more information about Mater Private Hospital Brisbane, please call 07 3163 1111.

Visiting hours

8 am to 8 pm (patient rest period 1.30 pm to 3.30 pm)

Our Mission

In the spirit of the Sisters of Mercy, Mater Health Services offers compassionate service to the sick and needy, promotes an holistic approach to health care in response to changing community needs and fosters high standards in health-related education and research.

Following the example of Christ the healer, we commit ourselves to offering these services to all without discrimination.

Our Values

  • mercy: the spirit of responding to one another
  • dignity: the spirit of humanity, respecting the worth of each person
  • care: the spirit of compassion
  • commitment: the spirit of integrity
  • quality: the spirit of professionalism

References: Milliman Care Guidelines Inpatient and Surgical Care 12th Edition 2008—Carepath Coordinator/Project Manager, Mater Children’s Hospital Brisbane.

Back to Top

Last modified 11:39 AM, 29 May 2014

HOSP-005-00795