Spinal Fusion Surgery
Either posterior spinal fusion surgery or anterior spinal fusion surgery is recommended when bracing or casting has been unable to stop the progression of the curve. These curves are usually greater than 50 degrees.
What is posterior spinal fusion surgery?
Posterior spinal fusion is a procedure in which a spine with excessive curvatures is permanently straightened. An incision is made along the back that goes through several layers of tissue and muscle to expose the spine. The surgeon(s) places metal implants (rods and screws) in the spine to straighten it uses bone grafts to fuse the spine into the new position.
What does fusion of the spine mean?
The fusion is when the bone heals to bone. The fusion keeps the parts of the spine in a corrected position. The part of the spine that is fused will no longer bend. When the fusion is done in the thoracic (chest) section, there is no significant change in flexibility since that region of the spine naturally has little range of motion. If the fusion extends into the lumbar (lower) region, there will be some change in your child’s flexibility but should not affect daily activity.
What are the implants made of and how long will they stay in?
The implants are made of titanium and cobalt chromium and will not be removed. Many parents ask if it is safe for their child to go through a metal detector or an MRI. The implants are safe, and your child will be able to have an MRI or walk through a metal detector.
What is bone grafting?
Bone grafting is used to help fuse the spine in the correct position. Parts of the spine are removed during surgery and used as the material for the bone graft.
What is spinal cord monitoring?
This is when electrodes are placed on your child after they are asleep. These electrodes monitor the brain’s ability to send and receive messages from the spinal cord and nerves. This test is done and monitored by a professional who is trained to administer and interpret this monitoring. This monitoring significantly lowers the risk of spinal cord injury during surgery.
Preparing for Surgery
Our surgery scheduling team will help you schedule a pre-operative appointment with your surgeon that is typically within one month of your surgery date.
A pre-visit appointment with anesthesia will be scheduled within one week of surgery. This appointment is a the main CHKD hospital in downtown Norfolk. You will meet members of our anesthesia team, meet the spine program coordinator, and visit the lab for pre-op blood work. If your child needs a pre-op CT scan, your surgery scheduling and radiology teams will help coordinate at your convenience.
We understand that preparing for surgery can be hard. At CHKD, our spine program coordinator is a registered nurse and will guide you through the process.
Length of Hospital Stay
Our AIS patient average length of stay is 3 days. These patients are on a Enhanced Recovery After Surgery (ERAS) protocol. Part of our ERAS is to use early mobilization which research has shown to provide a patient with the ability to get back to being a kid quickly.
Our patients sit up on the edge of the bed on the same evening as their surgery. On post-op Day 1, your child will work with physical therapy (PT) twice a day. On post-op Day 2, your child will work with PT three times a day, which will continue until they are discharged home. Patients and parents will learn more about what to expect during PT sessions when they attend their pre-operative class and work with a physical therapist.
Our neuromuscular patients' recovery and length of stay are unique to each patient. Your specialist will discuss the plan of care for your child.
Anticipated Recovery Time
Patients will see their surgeon(s) approximately two or six weeks after surgery. Some patients are ready to attend school for half-days as soon as two weeks after surgery. Most patients are able to return to school and limited activity within four to six weeks.
For the first six months after surgery, patients will be walking only. Their surgeon will determine if they are able to increase their activity after their three-month post-operative appointment.
Driving is prohibited while taking narcotic medication and/or for 6 to 8 weeks after your child’s surgery.
Pre-operative Spinal Fusion Class
Refer to Our Scoliosis and Spine Program