Your child must be assessed by your GP or a specialist before they can be referred to the Spine Service at the Starship Hospital. If the referral is accepted, an appointment will be sent directly to you. If you do receive an appointment, please turn up on the day because, if you do not turn up, you will deprive another patient of this valuable appointment.
When the Spine Service receives a referral there are two options:
- The referral will be returned to the GP and they will be asked to manage the condition based on expert advice given to him / her from a Starship doctor.
- An appointment will be sent to you with advice that there will be a waiting time before your child can be seen.
If you receive an appointment you will need to go to the Outpatient Department on Level 3 of Starship Children’s Hospital where your child will be assessed by specialised doctors. This usually takes several hours and may involve additional tests.
Recommendations and options regarding your child’s future treatment plan will be discussed with you.
Please bring to the appointment:
- Any letters or reports from your doctor or another hospital
- Any x-rays, CT or MRI films and reports.
If you have a condition that was caused by an accident, you will receive faster attention and treatment by seeing an orthopaedic surgeon outside the hospital under the cover of the Accident Compensation Corporation (ACC).
Who Will My Child See When They Come To The Spine Clinic?
Each clinic is headed by a specialist spine surgeon. However, due to the large number of children seen in each clinic, your child may be seen initially by a registrar (a registered doctor who is undertaking further specialised training). The registrar will discuss your child’s condition with the specialist who will decide on the plan of treatment. Starship Children’s Hospital is a teaching hospital. There may be medical or nursing students attached to a clinic. Please let the clinic staff know if you or your child do not feel comfortable having a student present.
What Happens At The Spine Clinic?
1. X-rays
X-rays of the spine are required at nearly every visit. X-rays assist the doctor to diagnose your child’s spine disorder and allow him to see the changes that may have taken place between visits. Modern x-ray machines ensure minimal exposure to radiation. You are welcome to discuss any concerns with the Radiology Department staff.
2. Medical and Family History
A complete medical history of your child and family will be taken. Your orthopaedic surgeon is looking for underlying medical conditions because some spinal problems can be associated with other disorders.
3. Physical Examination
The doctor will observe your child standing (front and back) and look for any asymmetry in the shoulders, rib cage, waist, and pelvis. Your child may be asked to put on a hospital gown because your doctor will need to view all of your child’s spine and hips as well as assess the skin for the presence of dimples, sinuses, hairy patches and pigmentation changes.
4. Neurological Examination
Sometimes neurological problems are the underlying cause of a spine disorder. A neurological examination includes evaluation of the function of the muscles and nerves of the upper and lower limbs. The following symptoms are assessed: pain, numbness, parasthesia (e.g. tingling), extremity sensation and motor function, muscle spasm, weakness, and bowel/bladder changes.
When your doctor has made a full assessment he will be able to discuss diagnosis and treatment options with you.
Due to the complex nature of spine disorders and the need for x-rays, please come prepared to spend several hours at the Spine Clinic.
Other Diagnostic Tests
In order to help your doctor make a diagnosis your child may require more specialised tests such as:
CT Scan: Computerised Tomography uses a combination of x-rays and computer technology to produce more detailed images of bones and internal organs. It creates cross-sectional images (like slices) of the inside of the body.
MRI Scan: A Magnetic Resonance Imaging Scan uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. It is used to evaluate the spinal cord and spinal nerves which can not be seen on an ordinary x-ray.
Bone Scan: Useful for diagnosing subtle or hidden bone fractures that may not show up on a routine x-ray, such as a stress fracture. Bone scans can also help detect causes of unexplained back pain.
These tests are not usually available on the same day as your initial clinic appointment. A separate appointment will be necessary. Your child will then have a follow-up appointment made with the Spine Clinic to discuss the results.
