What Is Spinal Fusion Surgery?

Doctors do spinal fusion surgery to help kids and teens with scoliosis or other spine problems.

It's called "fusion" because the surgery lets two or more bones in the spine (called vertebrae) fuse (grow together) into one solid bone. This straightens the spine and prevents the curve from getting worse over time.

Why Is Spinal Fusion Surgery Done?

Many kids with scoliosis don't need medical treatment. Others wear a brace to keep scoliosis from getting worse.

But some kids may need need spinal fusion surgery because:

• They have curves that can get too large for bracing.
• They're too old and their spines have finished growing. 
• They have a type of scoliosis that can't be helped with a brace.

The surgery will straighten the curve as much as possible and stop it from getting worse.

What Happens During Spinal Fusion Surgery?

Kids and teens having a spinal fusion will get general anesthesia. This lets them sleep through surgery. The operation takes several hours.

• After making an incision (cut) in the back, the surgeon makes cuts in the bone to put it in a straighter position.
• Then, the surgeon puts in rods and screws 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.
• Finally, the surgeon packs in bone graft (small pieces of bone) where the rods and screws are. This will eventually fuse the spine bones together.

What Happens After Spinal Fusion Surgery?

After a fusion, most kids stay in the hospital for a couple of days. That gives them time to recover from surgery and increase their movement. By the time they go home, they'll be able to walk around and do many day-to-day things (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 (such as pneumonia, constipation, or trouble eating).

Pain after surgery is treated with both prescription medicines, such as opioid pain medicines, and over-the-counter (OTC) pain medicines, such as acetaminophen and ibuprofen. Most kids take prescription pain medicines for less than 2 weeks to help them deal with pain and muscle spasms. Over the first 1–2 weeks after surgery, kids can gradually reduce the amount of medicine they take for pain.

How Can Parents Help?

To help your child heal at home:

• Encourage your child to walk or move around a little bit more each day. Start with light activity around the house, like going to get the mail or letting the dog out. Soon your child will be able to get out of the house to do normal activities like walking around the mall.
• Make sure your child doesn't drive or lift more than a few pounds until the health care provider says it's OK.

Your health care provider also will let you know when your child can go back to school. Most kids go back about 2–3 weeks after the surgery. Your provider will review specific activity restrictions after surgery. Your child will need to take a break from gym class and playing sports because the bones are still fusing. Let the school staff know your child will need help at first. The school can give your child extra time to get through the hallways or a second set of schoolbooks to keep at home.

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

What Else Should I Know?

After about 6 months to a year, the bones should be fully fused. The metal rods are no longer needed but they stay in the patient's back because they aren't doing any harm. Taking them out would involve another operation.

After a full recovery, kids can play sports and do the activities that they enjoyed doing before surgery.