Pediatric Orthopaedic Surgery Guide

orthopaedic surgeon looking at bone model

The prospect of having a child who needs surgery can cause considerable anxiety. The pediatric orthopaedic surgeons at Johns Hopkins have had years of experience performing each procedure they offer to patients. That fact, along with knowing what to expect on the day of surgery, can make the experience much easier. Surgery requires that a number of steps be completed to ensure that everything runs smoothly.

The Preoperative Visit

Once your surgery is scheduled, you will be asked to visit the clinic at the Johns Hopkins Outpatient Center. At this visit, usually a week before the operation, a general exam is performed on each patient. In addition, you may address questions and concerns with your surgeon. After the completion of the evaluation in the office, you will be sent directly for further tests in the Outpatient Center so that all of the pieces are put together for the day of surgery. The tests that are needed vary from person to person, but may include blood work or an electrocardiogram (EKG). At the pre-op testing center you will be given information that tells you when and where to go on the day of surgery.

Remember: DO NOT ALLOW YOUR CHILD TO EAT OR DRINK ANYTHING AFTER MIDNIGHT before the day of surgery to prevent cancellation of the procedure.

The Day of Surgery

In general, patients having surgery done by members of the Division of Pediatric Orthopaedic Surgery will need to report two hours before the scheduled time on the date of surgery to the Pediatric Pre-Op area. This is located on the seventh floor of the Blalock building at Johns Hopkins.


The surgery itself consists of several steps. The text below guides you through each of these. Other types of surgery follow the same basic steps. Please feel free to ask questions at any time to any member of our team.

Pre-op evaluation by the nursing team
The nursing staff in the pre-op area for pediatric surgery will take your child’s vital signs (blood pressure, pulse, etc.) and will ask you a few questions. This is also a time for you to ask any questions that you might have about the general procedures.

Pre-op evaluation by the orthopaedic surgeon
Drs. Sponseller, Ain or Leet will then greet you and perform a final brief exam. This is a great opportunity to ask any questions that have come up since your last clinic visit

Pre-op evaluation by the anesthesia team
A member of the anesthesia team will then ask you a few questions. This is a good time to ask about the pain medications that will be used during the surgery. He or she will then take you and one family member (if you desire) to the operating room.

Welcome to the operating room

  • Upon entering the operating room, you and your family member (if present) will be greeted by the surgical nursing staff. They will help make you comfortable in every way possible.
  • After the patient is sedated, the family member leaves the operating room and is escorted to the waiting area. He or she may kiss the patient before leaving.

The surgery procedure
The surgery will then performed. The doctors, nurses, and surgery staff will keep you updated as to how things are going.

For scoliosis patients: introduction of rod (instrumentation)
In the case of scoliosis surgery, the introduction of the rod is a very important part of the procedure.

Recovery Room

After surgery is completed, your child will be taken to the pediatric recovery room. The anesthesia team will get the patient settled in the recovery room at which time the family will be allowed in. Later your child will be taken from the recovery room to his or her room in the pediatric hospital.

Postoperative Care

The time your child will need to stay in the hospital and the kind of postoperative care he or she will receive varies for each kind of surgery. Your doctor can tell you what to expect. There is a whole team of nurses and doctors who will give your child the care that is needed until he or she is ready to go home.

Follow-up Care

It is important to make follow-up appointments as instructed by your doctor. This generally involves a visit the week after your child leaves the hospital. Follow-up after that as instructed by your doctor. The number to make an appointment is 443-997-2663.