Introduction. The British Scoliosis Society published a document in 2008 which set out the minimum standards for paediatric spinal deformity services to achieve over a period of time. But how do the UK paediatric spinal deformity centres measure up to these benchmarks?. Methods. We performed a telephonic survey, contacting every UK spinal deformity centre. The questionnaire probed how each unit compared to the recommended standards. Results. Twenty three centres were interviewed, covering 81 surgeons in total (range 1-8 surgeons per centre). Four centres (17%) did not have 24-hour access to a MRI scanner and all but 2 centres had on-site facilities for long-cassette films/scoliograms. Five centres (22%) always had 2 consultant surgeons per case, 9 centres (39%) routinely have only 1 consultant surgeon per case, and the rest had 1 or 2 consultant surgeons depending on seniority. Six centres (26%) did not routinely have shared care of their patients with the paediatric team. All centres used intra-operative SSEP monitoring, a minority used MEP monitoring (34%), and all but 2 centres had either direct or indirect supervision by a consultant neurophysiologist. All centres have cell saver units available with over half using them routinely (14/23). None of the centres used routine chemoprophylaxis. All units used thromboembolic stockings, with five centres (22%) routinely using foot pumps. Nineteen centres (83%) routinely sent their spinal deformity patients to ITU/PICU postoperatively. Our survey also asked each center what supporting facilities were available, whether they ran adolescent clinics, and whether they participate in multi-disciplinary meetings and audit. In addition, we questioned what typed of drains each center used and the length of time that patients were followed-up. Conclusion. This survey shows how the UK spinal deformity units stand up against the BSS standards, provides an insight in to current UK practice and highlights areas for improvement

We have examined how many and which potential complications (PCs) are recorded on the consent form by a group of consultant surgeons performing common spinal procedures - anterior cervical discectomy and fusion (ACDF) and posterior lumbar discectomy and/or medial facetectomy (PLD). Email survey. Consultant spinal surgeons performing ACDF and/or PLD practicing in Southwest England. Identification of the PCs each surgeon listed on the consent form for the specified procedures. There were 23 responses from 28 Consultant surgeons approached. 21 surgeons performed both ACDF and PLD, 2 performed only PLD. Surgeons quoted 5 to 17 (mode 10) PCs for ACDF and 4 to 15 (mode 13) for PLD. These did not necessarily represent the most common or most dangerous PCs recorded in the literature. 1,2. Small difference in PCs mentioned by Neurosurgeons and Orthopaedic surgeons was seen (ACDF mode: 12vs10, PLD mode: 12vs13). There was a strong correlation between the number of PCs recorded by surgeons for ACDF and PLD. We have found a wide variation in consenting practice amongst a group of surgeons performing common spinal operations. Issues of consent are common causes of formal complaints and potential litigation, causing anxiety for both patient and surgeon. A more homogenous consent process, employing objective measures where possible, may help reduce this burden and may be achieved by setting a national standard

Aims

Psychoeducative prehabilitation to optimize surgical outcomes is relatively novel in spinal fusion surgery and, like most rehabilitation treatments, they are rarely well specified. Spinal fusion patients experience anxieties perioperatively about pain and immobility, which might prolong hospital length of stay (LOS). The aim of this prospective cohort study was to determine if a Preoperative Spinal Education (POSE) programme, specified using the Rehabilitation Treatment Specification System (RTSS) and designed to normalize expectations and reduce anxieties, was safe and reduced LOS.