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Complex Spinal Surgery

What is Complex Spinal Surgery?

Complex spine surgery is a type of back surgery involving a fusion of six or more vertebrae. The vertebrae are a series of small interlocking bones extending from the skull to the pelvis (hip) to form your spinal column or backbone. Spinal fusion helps in forming a solid bridge of bone that stabilizes your back. The surgery may involve the placement of screws and rods within the spine and may take six hours or longer to complete.

When is Complex Spinal Surgery Indicated?

You may require complex spinal surgery if you have:

  • Spinal deformities, spinal tumors, or severe spinal trauma
  • Major and acute curvature from scoliosis (lateral bending) or kyphosis (outward bending) of your spine.

Pre-surgery Preparation for Complex Spinal Surgery

In preparation for complex spine surgery, you may be required to:

  • Stop using nicotine products of any type
  • Complete any other medical procedures (such as dental work) prior to the surgery
  • Consult a dietician if you are thin or overweight, as you need proper nourishment to recover well after the surgery
  • Participate in suitable exercises to strengthen your core muscles to help support the spine 
  • Keep a positive attitude

How does your Surgeon Perform the Procedure?

Your surgeon may take anywhere between 6 hours to 19 hours to complete the procedure. This would depend on the number of vertebrae involved and other contributing factors. During complex spine surgery, your surgeon:

  • Makes an incision down your back to access your spine
  • Removes the part of your vertebrae that are abnormal or deformed
  • Places bone grafts between your vertebrae or cuts and realigns part of the spine
  • Places hardware such as titanium rods, bolts, and screws to straighten or stabilize the spine
  • Takes X-rays to make sure vertebrae are correctly aligned
  • Closes the incisions with surgical staples

Usually, your surgical staples will be removed in about 10 to 14 days after your surgery. As your spine heals over the forthcoming months, your bone grafts fuse with your spine to form solid bone.

Risks in Complex Spinal Surgery

As with any surgery, complex spinal surgery carries certain risks and complications. These include:

  • Delayed healing
  • Failure of spinal fusion
  • Wound infection
  • Deep vein thrombosis
  • Pulmonary embolism
  • Urinary tract infections

Post-Surgery Protocol after Complex Spine Surgery

Following the surgery, you may be admitted to the Intensive Care Unit for close observation, monitoring, and care. You may be attached to and/or connected to a variety of equipment such as a pulse oximeter, a catheter, etc., as part of your post-surgical protocol. You will be advised to use a back brace the moment you are out of bed. 

Your hospital stay may last from 5 to 14 days depending upon your condition. You will be discharged from the hospital when the surgeon feels you are improving, and your vital signs are stable. Before you leave the hospital, your surgeon will give you instructions regarding the follow-up plan including medications, activity restrictions and lifestyle modifications.

Typically, your follow-up visits are scheduled at four to six weeks, three or six months and 12 months after the surgery. During each visit, X-rays may be taken to assess your progress.


Recovery from complex spinal surgery is always a long and difficult process. Generally, it may take anywhere between 6 months to a year for your vertebrae to completely fuse and become a solid part of your spine.