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Continuing Education in Anaesthesia, Critical Care & Pain 2006 6(1):13-16; doi:10.1093/bjaceaccp/mki063
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Continuing Education in Anaesthesia, Critical Care & Pain | Volume 6 Number 1 2006 © The Board of Management and Trustees of the British Journal of Anaesthesia [2006]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Scoliosis surgery in children

Michael A Entwistle, Specialist Registrar in Anaesthesia
Royal Manchester Children's Hospital, Pendlebury, Manchester M27 4HA, UK

Davandra Patel, Consultant Anaesthetist
Department of Anaesthesia, Royal Manchester Children's Hospital, Pendlebury, Manchester M27 4HA, UK
Tel: 0161 992 2439 Fax: 0161 992 2439 Email: davandra.patel@cmmc.nhs.uk (for correspondence)

The first 150 words of the full text of this article appear below.


Key points

Scoliosis is most commonly idiopathic in origin, but it may be congenital or secondary to neuromuscular disease, trauma, infection or neoplasm.

Surgery aims to correct the curvature, improve posture and reduce progression of respiratory dysfunction.

Cardio-respiratory dysfunction may exist as a result of progressive scoliosis or be related to coexisting disease, therefore careful preoperative assessment is required.

Intraoperative considerations include the prone position, avoiding hypothermia, minimizing blood loss and monitoring spinal cord function.

Good postoperative pain control is essential and requires a multimodal approach.

 

Scoliosis is a lateral curvature and rotation of the thoraco-lumbar vertebrae with a resulting rib cage deformity. It may be idiopathic or secondary to neuromuscular disease, infection, tumour or injury (Table 1).


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  		Table 1 Classification of scoliosis aetiology

 
Curvature is measured using the Cobb angle (Fig. 1). A lateral curve of >10° is considered abnormal.1


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  		Fig. 1 The Cobb Angle. Perpendicular lines are drawn . . . [Full Text of this Article]

 

   Natural history
 

   Surgical management
 

   Principles of anaesthetic management
 
Preoperative assessment

Idiopathic scoliosis

Non-idiopathic scoliosis

Anaesthetic technique

Positioning

Monitoring and temperature control

Blood conservation

Minimizing blood loss

Autologous blood

Neurological monitoring

Continuous intraoperative neurophysiological monitoring

Intraoperative ‘wake-up’ test

Postoperative management

Pain control

Fluid management


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