{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:42:13Z","timestamp":1791362533202,"version":"4.3.1"},"reference-count":54,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Neuromuscular scoliosis is a common feature in children with severe neurological impairment (SNI), including those with severe cerebral palsy. Surgical correction of scoliosis is the mainstay of treatment. This group of patients also have associated medical complexity. The complication rates post-surgery are high, although, for many, they are worth the risk. There are currently no published practice guidelines or care pathways for children with SNI who are undergoing scoliosis corrective surgery. In response to the high uptake of this surgery, coupled with the expected complication rates, our hospital established a perioperative clinic. The purpose of this paper is to describe our perioperative approach. This clinic has developed into a service beyond perioperative care and, with the collaborative meeting, enables shared decision-making to identify the right candidate for surgery. The process involves surgical expertise, understanding the family and child at the centre, and optimisation of medical care pre- and post-surgery. In this paper, we describe the process in a step-by-step manner. We provide clinical vignettes, as well as the proformas that we use, and we highlight the benefits of the team-based process.<\/jats:p>","DOI":"10.3390\/jcm11226769","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T02:36:36Z","timestamp":1668566196000},"page":"6769","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Perioperative Care of Children with Severe Neurological Impairment and Neuromuscular Scoliosis\u2014A Practical Pathway to Optimize Perioperative Health and Guide Decision Making"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3089-3244","authenticated-orcid":false,"given":"Giuliana","family":"Antolovich","sequence":"first","affiliation":[{"name":"Department of Neurodevelopment & Disability, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Neurodisability and Rehabilitation, Clinical Sciences, Murdoch Children\u2019s Research Institute, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Department of Paediatrics, University of Melbourne, 50 Flemington Road, Melbourne, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6589-8451","authenticated-orcid":false,"given":"Monica","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Neurodevelopment & Disability, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Neurodisability and Rehabilitation, Clinical Sciences, Murdoch Children\u2019s Research Institute, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Department of Paediatrics, University of Melbourne, 50 Flemington Road, Melbourne, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Melbourne, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Department of Orthopaedics, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Gait Lab and Orthopaedics, Clinical Sciences, Murdoch Children\u2019s Research Institute, 50 Flemington Road, Melbourne, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris","family":"Lundine","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Melbourne, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Department of Orthopaedics, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Gait Lab and Orthopaedics, Clinical Sciences, Murdoch Children\u2019s Research Institute, 50 Flemington Road, Melbourne, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Melbourne, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Department of Orthopaedics, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Gait Lab and Orthopaedics, Clinical Sciences, Murdoch Children\u2019s Research Institute, 50 Flemington Road, Melbourne, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Frayman","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Melbourne, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Department of Respiratory and Sleep Medicine, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Respiratory Diseases Group, Murdoch Children\u2019s Research Institute, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Centre for Health Analytics, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moya","family":"Vandeleur","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Melbourne, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Department of Respiratory and Sleep Medicine, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Respiratory Diseases Group, Murdoch Children\u2019s Research Institute, 50 Flemington Road, Melbourne, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Sutherland","sequence":"additional","affiliation":[{"name":"Department of Neurodevelopment & Disability, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Neurodisability and Rehabilitation, Clinical Sciences, Murdoch Children\u2019s Research Institute, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Department of Paediatrics, University of Melbourne, 50 Flemington Road, Melbourne, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Peachey","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tali","family":"Gadish","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Melbourne, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Paediatric Intensive Care Unit, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Paediatric Intensive Care, Clinical Sciences, Murdoch Children\u2019s Research Institute, 50 Flemington Road, Melbourne, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Melbourne, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Department of Anaesthetics, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Anaesthetics, Clinical Sciences, Murdoch Children\u2019s Research Institute, 50 Flemington Road, Melbourne, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Neurodevelopment & Disability, Royal Children\u2019s Hospital, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Neurodisability and Rehabilitation, Clinical Sciences, Murdoch Children\u2019s Research Institute, 50 Flemington Road, Melbourne, VIC 3052, Australia"},{"name":"Department of Paediatrics, University of Melbourne, 50 Flemington Road, Melbourne, VIC 3052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ejpn.2020.09.001","article-title":"Severe Neurological Impairment: A delphi consensus-based definition","volume":"29","author":"Allen","year":"2020","journal-title":"Eur. 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