Spinal Fusion Surgery

Overview

What Is Spinal Fusion Surgery?

Spinal fusion surgery is a treatment for spine problems like scoliosis (when the spine curves from side to side).

The goal is to straighten the curve as much as possible and prevent it from getting worse. The surgery fuses (joins) two or more bones in the spine called vertebrae into one solid bone. Because the fused section won’t bend or change shape anymore, the surgery is usually done once kids have reached their full adult height.

Top Things to Know

Doctors may do spinal fusion surgery to treat scoliosis and other spine problems.
The surgery can help straighten the spine and keep it from curving more.
Most kids go home a few days after surgery and recover well.
Medicine and physical therapy can help kids heal.

How It Works

When is Spinal Fusion Surgery Needed?

Doctors usually recommend spinal fusion when other treatments, like wearing a brace, don’t help enough to keep the spine from developing more of a curve. Braces work best while the spine is still growing and flexible. Once kids stop growing, the spine becomes stiffer, and a brace can’t guide it into a straighter position. In these cases, surgery may be a good choice.

Kids may need spinal fusion surgery because:

they have curves that are too large for bracing
they have a kind of scoliosis that a brace can't help
their spine has finished growing and the curve could get worse

What Happens During Spinal Fusion Surgery?

Before a spinal fusion, kids and teens will get general anesthesia, which lets them sleep through the surgery and not feel any pain. The operation will vary based on your child's needs.

Usually, the orthopedic surgeon makes an incision (small opening) in the back, and makes cuts in the bone to put it in a straighter position. Then rods and screws are put in to hold the bone in that straighter position. The metal parts are placed deep under the spine muscles. In most cases, they can't be felt and don't hurt. The surgeon then packs in bone graft (small pieces of bone) where the rods and screws are. This will eventually fuse the spine bones together.

The operation takes several hours.

how spinal fusion surgery works

Recovery

What Happens After Spinal Fusion Surgery?

After a fusion, most kids and teens stay in the hospital for a couple of days. That gives them some time to recover from surgery and slowly (and safely) start moving around. By the time they go home, they should be able to walk around and do many day-to-day things, like shower, dress themselves, and climb stairs.

Kids whose scoliosis is very severe or who have other medical conditions might need a longer hospital stay. Their care team will watch for and treat any complications, like pneumonia, constipation (problems with pooping), or trouble eating.

Pain after surgery is treated with both prescription medicines, like opioid pain medicines, and over-the-counter (OTC) pain medicines, like acetaminophen and ibuprofen. Most kids take prescription pain medicines for less than 1 week to help them deal with pain and muscle spasms. As kids start to feel better over the next few weeks, they typically need less pain medicine.

Home Care

Once kids are home after spinal fusion surgery, here’s how you can help them recover:

Encourage light movement. Try to have kids walk or move around a little bit more each day. They can start with light activity, like getting the mail or letting the dog out. Soon, they should be able to do normal activities like walking around the block or going out to eat.
Delay driving and lifting. Avoid letting your child drive or lift more than a few pounds until your doctor says it's OK.

Your doctor will give you specific activity restrictions (things your child shouldn’t do) after surgery.

School

Your doctor will let you know when your child can return to school. Most kids go back in about 3–4 weeks. Your child will need to take a break from gym class and playing sports because the bones are still fusing.

Let teachers know your child will need help at first, like extra time to get through the hallways. Kids may also be able to get a second set of books to keep at home so they don’t have to carry them to and from school.

Physical Therapy

Sometimes kids need physical therapy to complete their recovery. This usually starts about 4–6 weeks after surgery and can last several months.

What Else Should I Know?

After about 6 months to a year, the bones in the spine should be fully fused. Although the metal rods are no longer needed, they’ll be left in the back because they aren't doing any harm. Taking them out would mean having another operation.

After a full recovery, the spine should be stronger and more stable. Kids and teens should have less pain, better posture, and be able to do the activities they enjoyed before the surgery.

Every child is different, so the results of spinal fusion surgery can vary. Your doctor will talk with you and your child about what to expect.