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Spinal Fusion Surgery

Orthopaedic operation that permanently joins two or more vertebrae with bone graft and instrumentation to relieve pain caused by instability, degeneration or deformity.

Surgical Spine (cervical, thoracic, lumbar or sacral segments) Avg. stay 10 days 0 clinics

Overview

Spinal fusion is an orthopaedic or neurosurgical operation that permanently joins two or more vertebrae so that there is no movement between them. It is indicated for symptomatic spinal instability, spondylolisthesis, severe degenerative disc disease unresponsive to conservative care, recurrent disc herniation with mechanical back pain, certain spinal fractures and tumours, and as the corrective component of scoliosis or kyphosis surgery. According to AAOS/OrthoInfo, fusion can be performed at any spinal level (cervical, thoracic, lumbar or sacral). The operation combines bone graft - autograft (often iliac crest), allograft or synthetic substitute - with hardware such as pedicle screws, rods, plates or interbody cages to immobilise the segment while bony fusion matures. Surgical approaches include posterior, anterior, lateral and transforaminal corridors, and minimally invasive endoscopic or tubular techniques are increasingly used at high-volume centres. Lumbar fusion typically takes 3-5 hours under general anaesthesia; cervical fusion is usually shorter. Hospital stay is commonly 3-5 days, with NHS patient information for adult scoliosis surgery quoting up to 10 days for more extensive constructs. International patients usually remain in-country for 10-14 days for wound check and early mobilisation. Bony fusion typically matures over 3-12 months, with corresponding gradual return to activity and lifting limits. Sources: AAOS OrthoInfo, NHS Cambridge University Hospitals, NHS Royal National Orthopaedic Hospital, NICE.

Hospital & stay

2–3 nights
Hospital stay
10 days
Total stay abroad
Surgical
Procedure type

Procedure details

How it's performed

Under general anaesthesia, the patient is positioned prone (or supine for anterior approaches). The surgeon exposes the target vertebrae through a midline or minimally invasive incision, decompresses the neural elements if required, and prepares the disc space and facet joints for fusion. An interbody cage packed with bone graft is inserted into the disc space (or graft is laid posterolaterally), and pedicle screws and rods are placed to immobilise the segment. Image guidance or robotic navigation is used in many modern centres. The wound is closed in layers over a drain.

Preparation
  1. 1Standing radiographs, MRI and (where indicated) CT and flexion-extension views.
  2. 2Comprehensive medical and anaesthetic assessment; cardiopulmonary optimisation.
  3. 3Stop smoking 6-8 weeks before surgery - nicotine significantly impairs bony fusion.
  4. 4Pre-operative physiotherapy and education about log-rolling, transfers and post-operative exercises.
  5. 5Stop NSAIDs and certain biologic agents per surgical protocol to support fusion biology.
Recovery
  1. 1Day 0-1: Mobilisation with physiotherapy within 24 hours; pain controlled with multimodal analgesia.
  2. 2Days 2-5: Hospital discharge once mobile and pain controlled; oral analgesia continues.
  3. 3Weeks 2-4: Wound check and stitch removal; gentle walking and prescribed core exercises.
  4. 4Weeks 4-6: Most patients return to desk work; avoid lifting more than 5 kg and twisting/bending.
  5. 5Months 3-6: Imaging confirms early fusion; gradual return to low-impact exercise and driving.
  6. 6Months 6-12: Mature fusion; return to most sport and full lifting per surgeon advice.

Related procedures

Hip ReplacementKnee ReplacementScoliosis Surgery / Robotic Scoliosis

Related procedures

Hip Replacement Knee Replacement Scoliosis Surgery / Robotic Scoliosis

Clinical evidence on spinal fusion surgery

14 peer-reviewed sources

Spinal fusion permanently joins two or more vertebrae to stabilize the spine and is used for conditions such as degenerative disc disease, spondylolisthesis, deformity, and certain fractures. The peer-reviewed literature, including systematic reviews, meta-analyses, and comparative studies, examines surgical approaches (for example anterior, posterior, and interbody techniques), the role of biologics such as bone morphogenetic protein, and long-term outcomes including adjacent-segment changes and quality of life. Reported results vary by indication, technique, and patient factors such as obesity and bone health, and the evidence highlights both meaningful pain and function gains and a real profile of potential complications. Decisions about fusion are individualized and are typically considered after non-surgical options have been weighed. The references below are peer-reviewed and intended for general information, not as medical advice for any specific case.

  1. Paraspinal Musculature and Adjacent Segment Disease After Lumbar Fusion: A systematic review and meta-analysis of fusion with and without posterior instrumentation.
    McNamee C et al. · The spine journal : official journal of the North American Spine Society · 2026
    Systematic review & meta-analysisPMID 42242426DOI
  2. Stand-alone versus supplemented ALIF: a systematic review and meta-analysis of pseudarthrosis and reoperation rates.
    Riechelmann RS et al. · Neurosurgical review · 2026
    Systematic review & meta-analysisPMID 42234274DOI
  3. Single level versus multi-level lumbar interbody fusion for lumbar degenerative diseases: a systematic review and meta analysis.
    Alharbi DI et al. · Journal of orthopaedic surgery and research · 2026
    Systematic review & meta-analysisPMID 41832535DOI
  4. Balancing radiographic correction with quality of life: a meta-analysis of selective versus non-selective thoracic fusion in Lenke 1 C AIS.
    Awad G et al. · European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Meta-analysisPMID 41615441DOI
  5. Is Bone Morphogenetic Protein the new Gold Standard? A Meta-Analysis and Systematic Review of Bone Morphogenetic Protein vs Autologous Iliac Crest Bone Graft Use in Spinal Fusion.
    Arifin J et al. · Orthopedic reviews · 2026
    Systematic review & meta-analysisPMID 42136630DOI

Compiled from peer-reviewed medical literature indexed on PubMed. This overview is for general education and is not medical advice. · Last updated 2026-06-15