ABSTRACT
Most scoliosis surgery is performed by orthopaedic surgeons whereas operations for correction of neurological abnormalities are usually dealt with by either paediatric surgeons or neurosurgeons. Anaesthesia for spina bifida surgery and cervical spine stabilisation operations is covered in Chapter 38. Anaesthesia for scoliosis surgery is challenging and, as in many other aspects of paediatric anaesthetic practice, attention to detail is essential. A large team is involved in the preparation and assessment of the child, as well as the operation itself. The children may have associated abnormalities or physiological compromise. Incisions are large and operations can take many hours. There can be major haemorrhage and haemodynamic instability. The operations are also physically demanding
Introduction 553 Embryology and growth 553 Classification 554 Indications for intervention 555 Surgical and anaesthetic management 556 Management of blood loss 557
Spinal cord monitoring 558 Postoperative care 559 Duchenne muscular dystrophy 559 Friedreich’s ataxia 559 Late complications 560 References 560
and stressful for the surgeon. In all this, the anaesthetist will often act as coordinator and therefore needs to understand the role of each team member.
