Spine Fusion for Scoliosis
So, your doctor told you that you need a spine fusion…
A spine fusion is done to prevent your curve from getting worse. In most cases, this will decrease the curve size by about 50%. There are three types of spine fusions:
- posterior spine (from back of spine) fusion
- anterior spine (from front of spine) fusion
- anterior/posterior spine (from front and back of spine) fusion
The type of fusion you have depends:
- type of curve
- size of curve
- where the curve is located in your spine
- how stiff the curve is
- how much growth you have left
- other factors
In addition, your doctor may order one or more tests on your spine.
X-rays may be taken while you are lying down and/or bending to your right and left. This helps the doctor decide how much of your spine to fuse.
An MRI scan is used to find out if there is something in your spinal cord or brain that is causing your scoliosis. If something is found, we may need to address this before, or at the same time as, your spine fusion.
A CT scan gives us a better look at the shape of your back bones (vertebrae).
Not everyone will need these tests. You may need one or two or none. You and your doctor will figure out what is needed based upon your health history. Your doctor will explain to you the risks, benefits and alternatives to a spine fusion.
How is the spine fused?
A spine is fused using rods, hooks, screws, cables, and a bone graft. The metal we put in your spine acts as a brace until your own bone and the bone graft stick the vertebrae together.
Will my spine still grow?
The fused portion of your spine will not grow. The unfused portion of your spine will. You can also gain height from the growth areas in your legs. If surgery is done at age 12 or older, there is often less than one inch of growth left. Most people will gain ½” to 1” of height after surgery due to the straightening of the spine.
How big will the scar be?
If you are having a spine fusion from the back, you will have an incision down the middle of your back. The length will depend on how much of your spine is being fused.
If you are having a spine fusion from the front, the scar most often goes under your armpit around your side at the level of your nipple or bra line.
If you are having both a front and back spine fusion, you will have both.
Will the hardware be in forever?
We try to leave the hardware in. The hardware may become irritating. In these cases we may need to remove it. The surgery to remove the hardware is as big as the one to put it in. Your activity will be restricted for about 6 weeks. We like to wait 1 year from your spine fusion before taking the hardware out to allow time for the bony fusion to become solid.
What do you do for the pain?
During surgery, most patients have a thin tube (epidural catheter) placed within their spinal canals. Pain medicine is given through the catheter. You will also have pain medicine that goes through your IV. As you are feeling better, we will switch you to pain pills. You will also be able to take these pills at home.
Will I have a tube in my bladder?
Yes, you will have a Foley catheter that collects urine into a bag. This is put in while you are in the operating room and asleep. You will have this the whole time you have the epidural catheter.
How long will I be in the hospital?
Most patients stay about 5 days. You will most often spend at least one night in the pediatric intensive care unit. By the time you are ready to go home, you will be eating a small amount, urinating on your own, walking, going up and down stairs, and taking pain pills to control your pain.
How much school will I miss?
You may miss a few weeks of school. We have had kids go back anywhere from two to six weeks after surgery. It depends on how you are feeling and your endurance. Most often, we say you may go to school once you no longer need narcotic pain pills during the day. You may want to begin going back half days at first.
Getting Ready for Spine Fusion
When it is time to schedule surgery you will need to call our secretary, at 608-263-1344. She will schedule the date of your work-up visit and surgery. The work-up consists of a health history, physical exam, and signing the operative consent with our nurse practitioner. You will also need to have blood drawn at the lab and meet with the staff in the anesthesia screening clinic. We can set up a tour of the American Family Children’s Hospital while you are here for your work up to help you learn more about what to expect during your stay.
We have pediatric anesthesiologists who help with your care and monitor your spinal cord during surgery. This special monitoring is called SSEPS and MEPS. While in surgery, we are constantly testing your spinal cord integrity, like a circuit, to lessen the chance of spinal cord dysfunction.
We do many things to lessen blood loss, but there may be times when you will need extra blood. This blood can come from the blood bank, someone you know, or blood you donate yourself. If you want to have someone donate blood for you or you want to donate blood (and you meet certain criteria), contact our clinic nurse at 608-263-6420. You may want to check with your insurance company to see if blood donations are covered. If they are not covered, the cost is about $200 per unit, and you will be charged whether the blood is used or not.
You will come to the clinic for x-rays and follow-up at 6 weeks, 3 months, 6 months, and one year after surgery, and then yearly for 4-5 years.
First 6 weeks
- Incision care – We often use stitches that dissolve over time. You will also have steri strips (paper tape) across your incision. The steri strips may fall off at any time. This is ok. You may take them off after three weeks. You will change your dressing every other day. You will be shown how to do this. When the dressing is dry you no longer need a dressing. Your scar is very sensitive to sun, be sure to put extra sun screen on your scar if you are outside or it will burn
- Bathing – For the first two weeks, sponge baths only. At two weeks you may shower. At four weeks you may soak in a bathtub.
- Activity – Plan for lots of walking. You may go up and down stairs and slowly increase the distance you walk. Lift nothing more than a gallon of milk. Do not twist, turn or bend. Do not drive until 6 weeks after surgery, and you are no longer using narcotic pain pills.
6 weeks to 3 months
- Begin faster walking, stationary biking and a stair climber. We highly recommend light aerobics 3-5 times a week.
- You may lift up to 10 pounds.
- You may begin bending, twisting and turning within your comfort zone. Do not lift anything while doing this.
- You may float in a pool or lake, but no swimming or diving.
3 months to 6 months
- 3 months –Begin light straight ahead jogging on a flat surface and light swimming.
- 4 months –Increase the intensity of your jogging and swimming. Increase weight lifting to weights you can lift 15 times.
- 5 months to 6 months –Resume your normal routines. Slowly increase your time in a new activity so your body can adjust and you can adjust to how your body is able to move. We do not recommend activities that place a load on the back with the back bent (i.e. jet skiing, hopping waves, snow mobiling over jumps, etc.). The point where the fused and unfused spine meets can be damaged. If you have any questions please give us a call.
This handout is meant to act as a guide. Please talk with your doctor about your plan of care.
Important Phone Numbers
Clinic Secretary to Dr. Halanski and Dr. Noonan: 608-263-1344
Pediatric Nurse Practitioner 608-263-6420
Clinic Nurse 608-263-6420
If you live out of the area, please call 1-800-323-8942.
The Spanish version of this HFFY is #6295.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 05/19/2011
Copyright © 05/19/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6071
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