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Disability, pediatrics, management



  1. McMullan, Taralyn DNP, RN, CNS-BC


Purpose: Spinal fusion (SF) surgery is a complex procedure that affects children with and without underlying disabilities. The purpose of this article was to describe the necessary steps when preparing a child, specifically with cerebral palsy (CP), and family for an SF, while also emphasizing the postoperative care during discharge planning.


Design: Literature review on pediatric patients undergoing SF and those who have CP.


Methods: Literature was searched using the CINAHL database, from 2009 to 2016. Key terms included spinal fusion, cerebral palsy, pediatrics, orthopedic surgery, team approach, management and developmental disability, or disability. Literature was reviewed to provide recommendations on caring for children undergoing an SF who also have CP as little literature supports exact care measures on this cohort of patients.


Findings: Variations exist in the surgery type, specification, and approach, as well as history, growth, and developmental capabilities of the child and caregiver's expectations. Nurses must be aware of all of these factors to promote safe, effective, timely, and patient-centered care. In particular, patients with an underlying condition of CP may be more likely to experience complications that make understanding these processes essential to the surgery itself.


Conclusions: Although an SF may be a necessary surgery to correct a curve or spine deformity, there are many complications that a child with CP might encounter. The health care team must work closely with the child and the family to ensure that all treatment recommendations are met to minimize any unnecessary complications. Each surgery must focus specifically on meeting the child's and family's needs to ensure success while incorporating the health care team's approach.


Clinical Relevance: Providing patient and family-centered care for children having an SF is essential to optimize outcomes and improve quality of life for patients and caregivers.