Neuromuscular Scoliosis Spinal Fusion Clinical Pathway — ICU, Inpatient, Outpatient Specialty Care

Postoperative Inpatient Management

Postoperative Inpatient Management Expected through Discharge

All patients, once on the inpatient unit, should be managed as follows through discharge.

Clinical Area	Goals	Specifics
Hemodynamic	Stable	Monitor for decreased urine output
Respiratory	Return to baseline status Pulmonary toileting	Incentive spirometry q2 hours while awake, if appropriate Continue pulmonary toilet Chest PT and/or resume baseline respiratory regimen if appropriate and able to tolerate (IPV/cough assist, respiratory treatments) Consult pulmonary if followed at baseline
Activity/PT	Advance	Log roll q2 hours and PRN until patient can roll independently, if able Continue daily PT and OT Continue/advance: Ambulation 3x/day Out of bed (OOB) to chair 3/day Sequential compression devices (SCDs) while in bed and asleep. Use thoracolumbar spinal orthosis (TLSO) brace only if ordered per surgeon and if patient requests for comfort See additional resources on: Pressure Injury Prevention Interventions Job Aid Safe Patient Handling Procedure Using the Ceiling Lift After Spinal Fusion Job Aid
Laboratory/ Imaging	Monitor	Seated Scoliosis X-rays Complete once patient can tolerate before discharge Day 1 postop: 0600 phlebotomy round CBC (no diff) T&S Day 2, consider if abnormal from postop day 1

If you have questions about any of the clinical pathways or about the process of creating a clinical pathway, please contact us.

©2024 by Children's Hospital of Philadelphia, all rights reserved.
Use of this site is subject to the Terms of Use.

The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

Find a research study

Innovation and your child

Find research studies

Neuromuscular Scoliosis Spinal Fusion Clinical Pathway — ICU, Inpatient, Outpatient Specialty Care

Postoperative Inpatient Management

Postoperative Inpatient Management Expected through Discharge

Find a research study

Innovation and your child

Find research studies

Neuromuscular Scoliosis Spinal Fusion — Inpatient Management — Clinical Pathway

Neuromuscular Scoliosis Spinal Fusion Clinical Pathway — ICU, Inpatient, Outpatient Specialty Care

Postoperative Inpatient Management

Postoperative Inpatient Management Expected through Discharge