Vertebral Body Stapling

Vertebral Body Stapling

  • This recently introduced surgical technique to repair scoliosis replaces the traditional posterior spinal fusion and employs lateral positioning and a thoracic or abdominal exposure. The vertebral bodies are exposed and stapled into alignment. In general, this technique is associated with less blood loss than a traditional spinal fusion, but the potential for massive bleeding is remains significant.
  • Premedication: versed 0.5-1 mg/kg in response to patient's need, clinical status, and parents' input.
  • +/- thoracic epidural (asleep vs awake, consult with surgeon)
  • Usually an intravenous induction
  • +/- muscle relaxant/propofol to facilitate intubation of the trachea with double lumen tube (age appropriate, see section on lung isolation)
  • 2 peripheral IVs + arterial catheter
  • Blood products available
  • Lateral positioning
  • Neuromonitoring employed: SSEPs, MEPs; typically during infusion of propofol and fentanyl infusions with 0.5 MAC inhalational agent.
  • Awake extubation
  • Recovery in PACU
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This information is meant to serve as an educational resource. Clinicians should use their own professional judgment in the care of any individual patient as the guidance contained in this document may not be appropriate for all patients or all situations.