Nursing Care of the Postoperative Spine Patient Care

Nursing Care of the Postoperative Spine

Patient Care

Michael D Smith MDTwin Cities Orthopedics

October 2012

Objectives

bull Discuss indications for surgerybull Present perioperative

complications to watch forbull Review practical surgeon concerns

regarding nursing assessment biased toward cervical spine

procedures

Indications for Spinal Surgery

The Big Three

bull Neurologic compressionbull Instabilitybull Deformity

Pain -Indication for Surgery

bull Pain- unmanageable and associated with compression deformity or instability

bull Degenerative findings- common and incidental

Disc Herniation

Grade 1-4 based on

morphology and extension

beyond PLL

Neurological Indications

bull Pain numbness weakness tingling from cord or root compression

Instability

bull Spine unable to tolerate daily loads without excessive motion

bull Degenerative acquired post-traumatic neoplastic congenital

Traumatic

Instability

Degenerative

Instability

Cervical Deformity

Perioperative Complications

bull General medical- cardiac (MI) respiratory urologic pulmonary (UTI)

bull Specific- device related (posterior gt anterior)

bull Surgical- hematoma vascular or visceral injury infection

Clin Orthop Relat Res 2011 March 469(3) 649ndash657

Risk Factors for Complications

bull Pulmonary circulation 952bull Renal disease 555bull Metastatic Cancer 421bull Electrolyte abnl 397bull CHF 346bull Etoh abuse 116

Demographics for Mortality

bull Malebull Posterior vs anteriorbull Rural vs Urbanbull Older vs youngerbull A-American vs

Caucasian

Risk Factors for MortalityUnproven

bull DM simplebull DM complicatedbull Obesitybull PVOD

Common Cervical Spine Procedures

bull Anterior discectomyfusion -ACDFbull Anterior corpectomyfusion -ACCFbull Anterior discectomyreplacement -

ACD

bull Posterior decompression ndashforaminotomylaminaplasty -

bull Posterior fusion -PSF

Surgical Technique-Anterior DecompressionFusion

Operative Approach

bull Transverse incision -cosmeticbull Left sided preferred (recurrent

laryngeal nerve at less risk)bull Careful anatomic exposure

Incision Localization

Exposure Superficial Dissection

Exposure Deep Dissection

Completed Exposure

Fusion Bone Graft Insertion

Typical ACDF Fixation

Cervical Corpectomy

bull Anterior approachbull Extensive exposurebull Longer OR timesbull More complicated

stenosisbull Increased

complication rate airway dysphagia

Cervical Corpectomy

Cervical Disc Replacement

Posterior Procedures

bull Positioningbull Padding of

neurovascular points

bull Peruse facial-cervical area

Posterior Procedure Positioning


bull Adhere to demonstrated ROM to avoid impingement cordroot

Indications and Need for Nursing Care

bull Varied patient populationbull Varying neurologic presentationbull Broad age range and support

structuresbull Outpatient to lengthy

hospitalizations

Phases of Nursing Care

bull Preoperative

bull Education counseling support


bull Perioperative

bull Routines time outs counts cross pollination

Phase of Nursing Care

bull Postoperative bull Dependent on

nursing input and remote assessment

bull Typical defines patient perception f care

Complications

bull Anything that is touched moved looked at exposed intubated extubated cooled or heated can be injured

Postoperative Edema

Nursing Concerns

bull Tracheal obstruction- expanding hematoma lymphatic congestion vocal cord paralysis

bull Stridor- an impending arrest

Nursing Concerns

bull Esophageal ndash retraction local change in motility laceration

bull Indigo carmine for leak assessment

bull Difficulty ndashgt barium swallow steroids feeding tube

Esophageal Perforation


Displaced Bone Graft

Nursing Concerns

bull Neurological assessment- compare pre to post op status

bull Pain management ndash separate topic

Mental Health Issues

bull Anxietybull Depressionbull Somatizationbull Unrealistic expectations

Anxiety Disorders

bull 18 of general population (40M)

bull Pervasive and variable in expression

Kessler RC Arch Gen Psychiatry 2005

Jun62(6)617-27

Anxiety Disorders

bull OCDbull PTSD bull Social phobiasbull Specific

phobiasbull GAD

Depression

bull 10 of general populationbull Variable expressionbull Surgeons do poor job in pre-op

recognitionbull May coexist with anxiety

syndromes

Depression The 3 Rs

bull Reduced threshold for need for surgery

bull Reduced threshold for reporting pain after surgery

bull Reduced support systems and preop physical prowess

Substance Abuse240M in Risk Group

bull Chemical 5 12Mbull Alcohol 10 24Mbull Tobacco 19 46Mbull Associated mental health issue (ie

anxiety+Etoh) 54

wwwhhsgovodaboutfact_sheetssubstanceab

usehtml

Coping Skill Set PointReadjusted

Postoperative Anxiety

bull Assurancebull Adequate analgesiabull Anxiolytics-Ativan Valium Xanax bull Allied health approach (aroma

therapy massage music pets spouse)

bull Anticipation and preop teachingThe impact of preoperative information on state anxiety postoperative pain and

satisfaction with pain managementSjoumlling M Patient Educ Couns 2003 Oct51(2)169-76

Thank You

CONFLICT OF INTERESTCONFLICT OF INTEREST

I hereby certify that to the best of my knowledge no I hereby certify that to the best of my knowledge no aspect of my current personal or professional aspect of my current personal or professional situation might reasonably be expected to affect situation might reasonably be expected to affect significantly my views on the subject on which I am significantly my views on the subject on which I am presentingpresenting

Nursing Care of the Postoperative Spine Patient Care

Objectives

Indications for Spinal Surgery The Big Three


Slide 5

Disc Herniation Grade 1-4 based on morphology and extension beyond PLL


Instability

Traumatic Instability

Degenerative Instability

Cervical Deformity




Risk Factors for Mortality Unproven



Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs

Substance Abuse 240M in Risk Group

Coping Skill Set Point Readjusted


Thank You

Slide 53

CONFLICT OF INTEREST

Objectives

bull Discuss indications for surgerybull Present perioperative

complications to watch forbull Review practical surgeon concerns

regarding nursing assessment biased toward cervical spine

procedures


The Big Three





Disc Herniation

Grade 1-4 based on


beyond PLL



Instability



Traumatic

Instability

Degenerative

Instability

Cervical Deformity










Caucasian





ACD




Operative Approach






Completed Exposure



Cervical Corpectomy




Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53



The Big Three





Disc Herniation

Grade 1-4 based on


beyond PLL



Instability



Traumatic

Instability

Degenerative

Instability

Cervical Deformity










Caucasian





ACD




Operative Approach






Completed Exposure



Cervical Corpectomy




Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53





Disc Herniation

Grade 1-4 based on


beyond PLL



Instability



Traumatic

Instability

Degenerative

Instability

Cervical Deformity










Caucasian





ACD




Operative Approach






Completed Exposure



Cervical Corpectomy




Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53




Instability



Traumatic

Instability

Degenerative

Instability

Cervical Deformity










Caucasian





ACD




Operative Approach






Completed Exposure



Cervical Corpectomy




Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53


Traumatic

Instability

Degenerative

Instability

Cervical Deformity










Caucasian





ACD




Operative Approach






Completed Exposure



Cervical Corpectomy




Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53


Degenerative

Instability

Cervical Deformity










Caucasian





ACD




Operative Approach






Completed Exposure



Cervical Corpectomy




Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53


Cervical Deformity










Caucasian





ACD




Operative Approach






Completed Exposure



Cervical Corpectomy




Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53











Caucasian





ACD




Operative Approach






Completed Exposure



Cervical Corpectomy




Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53






ACD




Operative Approach






Completed Exposure



Cervical Corpectomy




Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53



Operative Approach






Completed Exposure



Cervical Corpectomy




Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53





Completed Exposure



Cervical Corpectomy




Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53




Cervical Corpectomy




Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53


Cervical Corpectomy












hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53













hospitalizations


bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53



bull Preoperative



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53



bull Perioperative






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53






Complications


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53


Postoperative Edema

Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53


Nursing Concerns



Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53


Nursing Concerns







Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53





Nursing Concerns





Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53




Anxiety Disorders




Jun62(6)617-27

Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53


Anxiety Disorders


phobiasbull GAD

Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53


Depression



syndromes

Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53


Depression The 3 Rs






anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53




anxiety+Etoh) 54


usehtml







Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53








Thank You




Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53





Objectives



Slide 5



Instability



Cervical Deformity







Operative Approach




Completed Exposure


Slide 24


Cervical Corpectomy

Slide 27




Slide 31



Slide 34


Complications

Postoperative Edema

Nursing Concerns

Slide 39


Slide 41


Slide 43


Anxiety Disorders

Slide 46

Depression

Depression The 3 Rs




Thank You

Slide 53


Nursing Care of the Postoperative Spine Patient Care

Documents

Transcript of Nursing Care of the Postoperative Spine Patient Care