In Scotland, paediatric and young adult spinal surgery service is commissioned by the National Services Division (NSD-NHS Scotland) and was designated a national service in 2005. This service is provided by the Spinal surgery team at the Royal Hospital for Sick Children (RHSC) in Edinburgh. The PICU is closely involved in supporting the Spinal surgery team in managing the complex Scoliosis (Syndromic; neuromuscular; or children with severe co-morbidities) patients post-operatively. The PICU team works closely with the spinal surgeons, physiotherapists, dietitians and pain team, and parents assisting the children in their journey to recovery after surgery. There is an on going audit on nutrition practices for the complex spinal surgery patients.