Università degli studi di Modena e Reggio Emilia

The present thesis deals with nursing healthcare given to the patient who imust undergo Arthrodesis Rear Instrumental surgery (APS) due to Scoliosis and Duchenne Muscular Dystrophy (DMD). The D.M.D. is a serious and crippling disease that affects the skeletal muscles and which causes serious malformations especially to the spinal column. D.M.D. affects children and ulimately leads to the death of the patient by the age of twenty.  A.P.S.  surgery  is useful in blocking the vertebral joints and it helps reduce scoliosis deformations caused by the D.M.D., or more simply, caused by the Scoliosis itself. Therefore, through this surgery, it is possible to delay the Cardio-respiratory complications caused by the disease. This type of surgery requires nursing healthcare which should specifically  tailored for each patient, especially after surgery when the assistance must be carefully evaluated according to the needs of the child-patient.

The thesis begins with an explanation of the anatomy of skeletal muscle and of the spine. It then deals with Scoliosis and Duchenne Muscular Dystrophy and highlights the characteristics of the Arthrodesis Rear Instrumental surgery (APS) indicating its benefits and limitations. Following this, the thesis illustrates the aspects that need to be investigated in the pre-operative phase, in particular during pre-admission. It iexplains the main procedures performed by the nurse in the surgery preparatory phase, starting from the patient and parents arrival in hospital till entrance into the operating room. After that, the thesis examines the characteristics of the procedures followed in APS surgery and the main elements of intra-operative nursing healthcare. Finally, the study concludes with some aspects of assistance starting from the early post-operative phase up to discharge from hospital.