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The RN circulator plays a vital role in preparing for a minimally invasive spinal fusion with navigation by confirming that the necessary equipment and stakeholders are available and ensuring that the amount of equipment and the number of people in the room do not compromise patient safety or the sterility of the surgical field. Patients who undergo minimally invasive spinal fusion experience less blood loss, shorter hospital stays, and reduced costs than those who undergo open spinal fusion procedures. The overall successful fusion rates and improvement in patient quality of life are equivalent between the two approaches. Using navigation during minimally invasive and open spinal fusion procedures decreases radiation exposure to the patient and surgical team and helps ensure a more accurate placement of pedicle screws compared with nonnavigated minimally invasive or open spinal fusions., (© AORN, Inc, 2018.)

Perioperative nurses care for patients undergoing a wide range of surgical procedures. One fast-growing surgical specialty is spine surgery performed using minimally invasive techniques. Patients may be candidates for minimally invasive spine surgery based on their presenting signs and symptoms and medical imaging test results. Open anterior and posterior surgical approaches to spine surgery are how surgeons traditionally have performed these procedures. However, new technology has enabled a minimally invasive lateral approach to the spine. This approach minimizes many of the risks and challenges associated with both the anterior and posterior approaches. Minimally invasive lateral interbody fusion requires the perioperative nurse to have a thorough understanding of the necessary patient positioning, spinal anatomy, and OR suite setup to ensure a safe and successful surgical experience for the patient., (© AORN, Inc, 2018.)

There are more than 12 million children with special healthcare needs (CSHCNs) in the United States, many of whom require specialised health-care to treat chronic physical and developmental conditions. This study is a qualitative investigation of programme, surgical and at-home recovery experiences among CSHCNs and their family carers who participated in a spine surgical care programme at a paediatric hospital in the Western United States. The programme is designed to manage increased surgical risk and the transition of care from hospital to home for children with severe scoliosis undergoing spinal fusion surgery. We conducted 30 semi-structured in-depth interviews with 14 surgical team members and 16 family carers of children who had programme evaluations and spinal surgeries in 2006. Data were collected in 2008 and 2009 in hospital or at home locations to gather programme participation feedback from families and inform the adequacy of programme support to families during at-home recovery. Data were analysed by reflexive team and content analysis methodologies. Results showed the programme was effective at improving preoperative surgical evaluation and helping families to anticipate some aspects of the surgical experience and hospital discharge. However, the impact of spinal fusion surgery and the subsequent transition to home-based care was profoundly emotional for patients and their carers. Our data indicate that programme providers underestimated the extent of emotional trauma experienced by patients and families, particularly during the at-home recovery process. The data also suggest meaningful differences in providers' and carers' expectations for surgery. Carers' disappointment with their recovery experiences and the perceived lack of post-discharge support impacted their interpretations of and perspectives on their surgical experience. Implications of this research for surgical care programmes include the need for assessment and provision of support for physical, social, and emotional burdens experienced by patients and carers at pre-surgical, surgical and at-home recovery phases., (© 2013 John Wiley & Sons Ltd.)

AS MUCH AS 80% OF THE US POPULATION will be affected by back pain at some time during their lives. Some of the most common disorders are herniated disc, degenerative disc disease, degenerative spondylolisthesis, spinal stenosis, and revision of previously failed low back surgery. IF CONSERVATIVE TREATMENT for back pain fails, spinal fusion may be performed. Anterior lumbar interbody fusion effectively manages degenerative joint disease, instability, and spondylolisthesis. NURSES WHO PROVIDE CARE for patients undergoing this procedure help ensure patient safety and promote positive outcomes.

Anterior cervical discectomy and fusion (ACDF) is a surgical procedure proven successful in the treatment of symptoms caused by cervical degenerative disc disease that is unresponsive to conservative therapy. Retrospective studies of patients who have undergone ACDF indicate that this procedure has a high rate of success for relieving symptoms and a low rate of associated complications. This article discusses normal cervical spine anatomy, the pathology of degenerative cervical disc disease, and perioperative nursing care for patients undergoing ACDF. Cortical ring allograft bone grafting and internal fixation with cervical locking plates also is discussed.

A new development in spinal surgery uses cylindrical fusion devices for fixation and fusion. Two products, which involve differing procedures, instrumentation, and implants, have been used for more than two years and are becoming more popular as excellent fusion and recovery rates have been reported. This article discusses the historical background of surgery for spinal fusion and describes the preoperative preparation and procedures for both of the products. The conclusion summarizes postoperative care, patient teaching, and preventing possible complications.

Anterior discectomies and fusions are performed on patients who have anteriorly herniated discs. Fusions are accomplished using bone grafts harvested from the patient or by using cadaveric bone grafts that are inserted into the disc space for stability. This procedure traditionally has been performed through an open incision, but now can be accomplished using a video-assisted thoracoscope. The benefits of this minimally invasive technique for patients include decreased blood loss, less postoperative pain, and a shorter hospital stay.

Laparoscopic procedures, such as spinal fusions, facilitate patients' faster returns to functioning lifestyles. Fusions using implanted threaded cylinders made of a porous titanium alloy can be performed at the cervical, thoracic, and lumbar spine levels. This article discusses preoperative, intraoperative, and postoperative care of patients undergoing laparoscopic spinal fusion.

Transoral resection of an anterior spinal cord tumor consists of three major phases: corpectomy (i.e., removal of vertebral bodies), tumor resection, and duraplasty (i.e., repair of the dura mater). A second surgical procedure, posterior stabilization of the occiput to the C3 vertebra, consists of an iliac crest bone graft for cervical spine fusion and the application of a rigid fixation device. This article describes a patient who underwent a transoral resection of an extramedullary intradural tumor at the C2-C3 level of the spinal cord and a posterior cervical spine stabilization procedure. Perioperative nursing concerns and interventions are discussed from the standpoint of the patient's physical and mental postoperative recovery.

Innovative surgical approaches to current adult lumbar scoliosis result in faster recovery time and greater satisfaction regarding patient abilities after surgery. Combined ASF/PSF requires expert surgical team coordination throughout the perioperative period to achieve positive patient results.