Pediatric cervical spine surgery

Overview

Pediatric cervical spine surgery can be performed in children who have injuries or conditions that affect the bones of the neck. The neck part of the spine is known as the cervical spine.

Cervical spine conditions may be present at birth. Or they may result from an injury such as a car or motorcycle accident. Cervical spine conditions that occur at birth, known as congenital, are not common. They most often occur in children who have a disease that affects the cervical spine. Or they may occur in children with congenital changes in the bones of the neck.

Cervical spine conditions can lead to compression or damage to the spinal cord and nerves. This compression may cause symptoms such as trouble walking, urinating or doing fine motor activities. Relieving this compression can help prevent further symptoms.

Why it's done

Pediatric cervical spine surgery may be done after a cervical spine injury or when a child has a condition that affects the spine.

Your child's surgeon may remove portions of the bone that is compressing nerves or the spinal cord to help prevent loss of nerve function. Sometimes pediatric cervical spine surgery is done to correct instability between the bones, which may injure the spinal cord or nerves. Metal implants including rods and screws may be used to connect bones, known as fusion, and to prevent excessive motion. This can reduce neck range of motion.

Risks

Pediatric cervical spinal surgeons must account for the child's future growth and development.

Possible risks of pediatric cervical spine surgery include:

• Bleeding.
• Spinal cord or nerve injury.
• Infection.
• Deformity.
• Neck pain.

How you prepare

You may need to schedule tests for your child before pediatric cervical spine surgery. Also let your child's healthcare professional know of any medicines or dietary supplements your child takes.

The day before surgery, follow the instructions you received from your child's healthcare professional. In general, have your child stop eating solid foods eight hours before your child is scheduled to arrive for surgery, but continue to encourage liquids. Six hours before arrival, have your child stop eating all foods and stop drinking nonclear liquids. This includes formula, milk and orange juice. Also stop giving feedings through a tube if your child has a feeding tube. Breast milk, water, clear fruit juice, Pedialyte, gelatin, ice pops and clear broth are OK.

Then, four hours before the arrival time, stop giving breast milk but continue to encourage your child to drink clear liquids. Two hours before report time, have your child stop drinking all liquids and stop chewing gum.

Check with your child's healthcare professional about what medicines your child may take before surgery. Some medicines can be given before surgery.

What you can expect

Before the procedure

Your child is put under general anesthesia for any pediatric spine procedure, including pediatric cervical spine surgery. Your child also may be given a sedating medicine before the procedure.

Before cervical spine surgery, your child may be placed in a device that keeps the spine stable. These devices may include a cervical collar or halo vest.

During the procedure

The most appropriate surgical approach depends on the location that's being operated on. The surgeon may make an incision on the back of the neck. Sometimes an incision is made in the front of the neck.

During the procedure, the surgeon removes bone that presses on your child's spinal cord or nerves.

Sometimes a spinal fusion procedure is needed to connect two or more bones. The surgeon may insert plates, screws, rods or wires to stabilize the spine and achieve fusion. A bone graft also may be used. During a bone graft, a bone is transplanted from another area of the body or a donated bone is used.

After the procedure

After surgery, your child stays in the recovery area until waking from the anesthesia. Most of the time, you're able to see your child in the recovery room.

The length of your child's hospital stay depends on the type of surgery that was done. But often children stay in the hospital 1 to 2 days after pediatric cervical spine surgery.

Most children can return to school within a week or two and can begin participating in physical education about 2 to 3 months after surgery. Some children wear a brace or special device such as a halo vest to help the neck heal after surgery. Children can return to all activities within 3 to 6 months after surgery.

Children don't usually need physical or occupational therapy after surgery.

Results

Pediatric cervical spine surgery is often successful. The surgery usually is only performed when absolutely necessary in children to reduce the risk of neurologic issues.