Spinal surgery

Having spinal surgery can be a daunting prospect. We hope the information on this page makes you feel more prepared and less anxious.

Please talk to a member of our spinal surgery team if you have any further questions or concerns.

Information about the surgery

MRI scan

All patients having spinal surgery need a MRI scan. This is so we can check the spinal cord.

The MRI scanner is on level 1 – Arctic, at Evelina London Children's Hospital.

Find out more about having an MRI scan.

Occasionally you may also need a CT scan to assess your spine. This is a type of X-ray, similar to having an MRI.

Pre-assessment clinic

You will need to attend our pre-assessment clinic, normally around 4 to 6 weeks before your surgery.

Here you will meet members of the team who will be looking after you. We will also carry out some tests, including blood tests, spinal X-rays and heart tests (ECG).

Find out more about the pre-assessment clinic.

At home

There is not much preparation needed at home. However, it's important you sleep in a standard bed that is easy to get in and out of, rather than a bunk bed.

It can be helpful to let your school know about your operation. Your nurse can give you a letter to send to your school, explaining your procedure.

If you're feeling unwell on the day of your admission, or even a few days before, please let us know.

The day before

You will be admitted to Savannah ward the day before your surgery. Surgery normally takes place on a Wednesday or a Friday.

Please phone the ward on 020 7188 5949 before you leave home, to check your bed is available, and arrive on the ward before midday.

When you arrive at hospital we will carry out further tests and observations.

You will meet your surgeon, orthopaedic doctors and anaesthetist again. A pain nurse specialist will come and talk to you and pain relief.

You will be able to visit the intensive care unit (PICU) at this time. This is where you will wake up after your operation.

Before you got to bed, we will give you a special wash solution to shower in and a nasal ointment for you to use. This is make sure you are clean for surgery.

On the morning of surgery

There may be two patients having spinal surgery on the same day. If this is the case, the first patient will go to theatre at 7.30am to 8am, and the second patient will go at midday. We'll tell you the day before your operation when you are going, so we can prepare you.

Before an operation you cannot eat or drink anything for a few hours before – we will let you know when you need to stop eating and drinking.

You will need to get up about an hour and a half before your surgery, shower again and use the nasal ointment.

We will give a theatre gown to wear, and special stockings to prevent blood clots. Your nurse will put some numbing cream on your hand (ELMA) – this is to stop you feeling anything when the anaesthetist inserts a needle into a vein on your hand for the anaesthetic (medicine to help you fall asleep).

About an hour before the operation, we will give you some oral pre-medication (a medicine to help you relax). This may make you feel a little dizzy, so please rest on your bed after you take this.

When the operating theatre is ready, a porter will collect you and your parent or carer and take you into the anaesthetic room (next to the the theatre). Here the anaesthetist will give you the anaesthetic. Once you fall asleep, your parent or carer will be taken back to the ward and you will go for your surgery.

Find out more about having an anaesthetic.

In intensive care (PICU)

You will wake up in intensive care (PICU) or post operative care recovery.

When you wake up, you may notice a few tubes and lines have been put in while you were asleep. These are only in place a short time. They help us monitor you and to give you medicine.

Initially after surgery, your family may notice that your face is puffy. This is a result of being positioned on your front for so long during the operation and will soon disappear.

You may have to lie flat for around 12 hours after surgery, to help let your wound settle. Once you are fully awake you can start to eat and drink again.

You may feel a bit sick after the operation, but we can give you medicine to help.

Pain relief

You may worried that you will be in pain after the operation. However, although you may feel achy and groggy for a few days you shouldn't be in pain as we will give you regular pain medication.

If you are in pain please tell your parent or carer and your nurses and we will try and help you.

Back on Savannah ward

You will usually come back to Savannah ward on the evening of your surgery or the next day.

Usually by the afternoon of the first day after your surgery, or the second day, you can start to get out of bed. The physiotherapists will help you with this, and give you exercises to do to help you recover.

By the second and third day, most of your tubes and lines will have been removed. You can have a wash and wear your own clothes. Loose and cool clothes like t-shirts and tracksuit bottoms will be the most comfortable and easiest to get on and off.

We will also change your wound dressing around this time, replacing the pressure dressing with a smaller, lighter dressing which looks like a large plaster.

Over the next few days, we will continue to monitor you and help you build up your strength. By the fourth or fifth day we will take some more X-rays of your back. This is exciting as you can see what your back looked like before and after your operation.

If you need a back brace, you'll be measured for this before you go home, and booked into the orthotic clinic to get it fitted (one to two weeks after your operation).

More information about having a back brace is in our patient information leaflets.

Before you go home, we need to make sure that:

you're eating and drinking well
you're going to the toilet normally,
your pain is well-controlled
your wound is dry
you're moving about
your surgeon is happy with your x-ray.

We will provide transport home for you and one parent/carer.

At home

It is normal to feel tired for a few weeks after the operation. You have had a big operation and it will take time to recover.

It's important to build up your stamina, so try and be active, but you should avoid all sports. We will provide you with some exercises to carry out at home.

When sitting, sit in a chair with good support (with backs and sides) and avoid soft sofas that might be hard to get out of.

You can travel in car as soon you can sit comfortably.

We will give you pain medicine to go home with. We will advise you on the best way to take these.

You may also feel a little constipated after the operation. We will give you medicine to help with this when you go home.

Looking after your wound

Please try to keep your dressing dry. 10 days after your surgery, an appointment will be made with the nurse at your local GP surgery to remove the paper stitches (steri-strips) and dress the wound.

The nurse will continue to dress your wound until it is dry. He or she will give you a supply of dressings to take home with you. Look out for any signs of your wound being infected, including redness, oozing or increased pain or tenderness.

Your back incision may be numb for 4 to 6 months and feel sensitive and tingly. This is normal, and is due to the tiny nerves in your back regenerating.

The wound normally heals after 14 days, and then the dressing can be left off.

Once the wound is healed, you can have a shower. A shower is better than a bath as it puts less strain on your back.

You can usually return to school 2 to 4 weeks after surgery. It's best to go back part-time at first, until you're ready for a full school day.

You will not be able to do PE or sports four to six months after the operation. Heavy lifting, including school bags and books is also not allowed until about six months after the operation.

You may find it easier having 2 sets of textbooks (one for school, one for home) or ask a friend to help.

When sitting for a long time at school you may need to stand up or stretch, or leave the class early. Talk to the teacher about dealing with these issues, so that they understand your needs.

You will have a number of follow-up appointments after your operation:

6 weeks after your operation – here you will have an X-ray and the surgeon will review your wound
6 months – you will see your consultant at this appointment. At this stage you can start gentle PE and swimming but no contact sports.
1 year – you will see your consultant again at this appointment. Most children can return to normal activities one year after surgery. Please discuss activities such as theme park rides, trampolining, rugby and high jump with your surgeon.

If you are concerned that you have not been contacted about follow-up appointments, and you think the appointment may be overdue, please contact us on 020 7188 4000.

If you cannot sit comfortably long enough to travel to these appointments, you can book hospital transport.