The insertion of various rods, frames, or other fixation devices that act as internal splints until the vertebrae involved in the curvature fuses, correcting deformity.
Discussion
Scoliosis is described as a lateral “S” or “C” deviation of the spine, which may include a rotation or deformity of the vertebrae. Scoliosis can be idiopathic or congenital, and may result from muscular or neurologic disease.
Surgical treatment is usually performed when musculoskeletal and respiratory functions become compromised or for cosmetic purposes.
Indications may also include an increase in spinal curvature in a growing child or pain from the curvature in adults, uncontrolled by conservative methods.
Positioning
Prone, on a Wilsom frame or chest bolsters with arms placed on armboards, angled to wand the head; hands pronated.
Packs/ Drapes
Laparotomy pack
Sterile adhesive drape
Extra drape sheets
Towels
Minor pack
Instrumentation
Laminectomy tray
Kerrison and pituitary tray
Spinal fixation device tray
Steinman pins and protractors
Self-retraining retractor
Supplies/ Equipment
Special frame; positioning aids
Suction
Fiberoptic headlight
Cell saver
Cast cart
Basin set
Blades
Needle counter
Bone wax
Medications
Solutions
Closed drainage systems
Procedure
Harrington Rod with Fusion
The appropriate incision is made, and the vertebral levels are identified.
Muscular and ligamentous structures are denuded from the spinous processes laterally to the transverse processes on both sides before placement of the rods.
Distractor hooks are placed on the concave side, and the distraction rod is then placed.
Hooks for the compression rod are also applied.
Large amounts of cortical and cancellous bone placed over the rods and the denuded area.
Suction drains are placed and the wounds are closed.
Perioperaitve Nursing Considerations
The individual is placed in a posterior plaster shell or Rizer jacket for approximately 6 to 12 months or until fusion is solid.
Have X-rays taken in the room.
Check with blood bank for available units.
Measure blood loss accurately.
Have additional suction available if cell saver is not used.