- Imaging: X-rays or a CT scan are requested 24–38 hours postoperatively to ensure appropriate metalwork placement and alignment.
- Analgesia: Intravenous opiate analgesia is often required in the initial postoperative period. Oral nonsteroidal anti-inflammatory drugs should be used thereafter. Diazepam can be helpful in the management of postoperative pain due to muscle spasm.
- Antibiotics: Prophylactic antibiotics should be given according to local policy. This should not exceed 24 hours; there is no role for extended antibiotic therapy.
- Wound care: Wound dressings should remain clean, dry, and undisturbed unless soiled. The wound should be inspected and dressings changed prior to discharge.
- Wound drains: If a drain has been placed, it should ideally be removed within 24 hours of surgery.
- Physical therapy: Children should be mobilized as soon as pain control permits. Postoperative orthotic support will not be routinely required following adequate internal fixation but may help in early pain control.
- Incisional pain: Neck stiffness is common in the early postoperative period but resolves spontaneously in most cases. A hard cervical collar may afford relief during this period.
- Swallow/speech difficulties: These symptoms may complicate anterior cervical procedures, particularly where multiple-level access has been required. Both are usually self limiting.
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