1:15 PM Mountain Time
Claire is out of the OR. Tiffany and I just met with Claire’s surgeon and he was pleased – “psyched” was the word he used – with how the surgery went. Claire just arrived on the PICU floor and we will get to see her in 90 minutes.
Because of the severity of Claire’s scoliosis and kyphosis and because of her ongoing conditions, Claire’s care team elected to go with a spinal fusion. The other options available included growth rods which move with her spine as she grows. These are more appropriate for patients with more mobility than Claire.
Step 1: Make Room to Reposition the Spinal Column
The 100+ degrees of curvature for Claire in two directions leaves little wiggle room for the spine to shift. So the first step was to make her spine more maneuverable. The doctors removed cartilage between each vertebra. “Well then won’t the bones just rub together?” was a question we asked and heard from others.
No. The fusion of the spine creates a single entity, so no abrasive, adjacent movement takes place.
Step 2: Make the bones bleed
The hardware that is installed in spinal fusions is not what ultimately holds the spine together. The bones fuse to one another biologically. In order to promote the vertebrae healing (“fusing”) together, each vertebra is roughed up and made to bleed. As they heal, they fuse together into a single, rigid column.
Step 3: Stabilize the spine
The hardware is to maintain the shape while the spine fuses biologically. Two rods and multiple screws were anchored to implants in the bone. The first rod bears the brunt of the stress while the second rod plays the supporting role.
Step 4: Build barriers for infection
Scoliosis and Kyphosis surgery has some of the highest infection occurrences of all procedures. So finding a care team that has a record of stellar infection control is critical. Children’s Hospital Colorado is renowned for their infection control.
One way of mitigating infection risk is to pack a substance around the spine replete with antibiotics. These are the first guard against infection.
Step 5: Sew her up
Sutures around the muscles, then the subcutaneous fat layer and finally the skin close the incision.
And now we wait…
We were told Claire was still intubated by the surgeon and then learned (5 minutes ago) that the care team were able to extubate Claire. So she is off the ventilator and breathing on her own!
We will provide another update later this week before we get discharged.