Complex Care: Team Management In Spinal Fusion for Children with Cerebral Palsy
Presenters: Mohan Belthur, MD, FRCS (Tr & Orth), FRCS(C), Dr. Ranjit Varghese, Irene Dietz, MD, FAAP, Gina Rempel, MD, FRCPC, FAAP, Lisa Letzkus, Ph.D., RN, CPNP-AC, CCRN, & Holly Beth Roach, OTR, ATP
Spine deformity is common in children with neurodevelopmental disabilities especially cerebral palsy. Surgical intervention presents management challenges to their families and care teams because of the complex interplay of co-occurring conditions. Decreased pulmonary function, inadequate nutrition, seizures, infection and immunodeficiency, coagulopathies, decreased mobility, communication and cognitive difficulties may all be present.
Protocol-based care has been shown to successfully decrease the number of days on mechanical ventilation, improve mortality from sepsis, reduce costs of hospitalization, and reduce the incidence of drug-resistant bacterial infections. A high-risk spine protocol helps patients by having dedicated professionals in multiple specialties focusing on all aspects of a patients care in the pre, intra and postoperative phases. This course will present the current knowledge informing providers for children with NM disorders in this process.
Understand the prevalence of scoliosis in children with cerebral palsy, risk factors for developing scoliosis, natural history, treatment options, and outcomes of surgical treatment, complications and related healthcare costs.
Identify modifiable risk factors and co-occurring conditions including airway, pulmonary, cardiac, nutritional, musculoskeletal, and psychosocial issues should be evaluated and treated before undergoing high-risk spine surgery
Understand how dedicated multidisciplinary team involved throughout the pre-, intra-, and postoperative periods improves patient outcome
Integrate how protocol-based care in spine surgery may lead to reduced complications and better outcomes with reduced length of stay and overall improved patient outcomes
Discuss how shared decision-making and adequate preparation of the family before surgery improves outcomes
The AACPDM would like to thank these presenters for generously volunteering their time to present this eCourse.