Anterior and Posterior Spinal Fusion: What to Expect for Your Surgery

When your doctor recommends a surgery called anterior and posterior spinal fusion, you have a right to be a little nervous. Those are a bunch of scary sounding words that only a fool would take casually.

By this point, you have already tried a spinal nerve block injection. But the pain is persistent.

Naturally, you have questions if you or someone you love is up for that particular procedure. Of course, you have asked your doctor all the questions that came to mind at the time. But that is never enough. The really good questions don’t occur to you until much later.

This article is no substitute for a conversation with your surgeon. But, having already had that conversation, this should help fill in some of the gaps.

What you really want to know is that at the end of the process, everything is going to be all right. There is good news. For this procedure, the fusion rate is greater than 95%. You are most likely going to be just fine.

But to get from where you are to being just fine, there is a road on which you must travel. That’s the scary part. The truth is always less frightening than the nightmare conjured by your worst fears. Knowing exactly what to expect is a great way to tame the beast. Here is what you can expect from your surgery:

Anterior and Posterior Spinal Fusion (Timetable)

Anterior and posterior spinal fusion is major surgery. Here are some numbers associated with the surgery:

8 – 12 hours: The amount of time the surgery takes
7 days: The expected hospital stay after surgery
4 days: The amount of time the chest tube is in
20 minutes: The maximum time you can sit up per session shortly after surgery
14 days: The minimum time before the staples are removed
6 months: The amount of time for the fusion to become solid

There are other numbers that fall into the category of “to be determined (TBD).” Those numbers include the time elapsed before you can return to work. All of these numbers make a lot more sense once you realize what the surgery involves.

Anterior and Posterior Spinal Fusion (Procedure)

As with most surgeries, you are not to eat or drink anything after midnight prior to surgery. It is a very long procedure done in two parts. Studies show it is better to have these parts done as a continuous procedure than staged over time.

There will first be some bone removed from your hip to be used in the fusion. From there, the anterior portion of the procedure will begin.

The Anterior Lumbar Interbody Fusion consists of an abdominal incision, and repositioning of major blood vessels to expose the damaged disk.

That disk is removed and replaced by the bone material. If normal spinal compression is not enough to hold the bone in place, a screw may be used.

Once this portion of the surgery is completed, you are turned over for the remainder of the procedure.

More disk material is removed, and more bone grafts are performed. More hardware such as rods and plates are applied as determined by the doctor.

It is normal for an NG tube to be inserted to prevent you from being sick afterward. Also, expect a chest tube to be inserted. This will aid in diagnostics for the first few days you are in the hospital.

It is not important that you have an encyclopedic knowledge of the surgical details. The takeaway is that these procedures are not new. They are tried and true. You should take comfort from the fact that these details are common knowledge. It has been successfully done countless times before you experience it.


Anterior and posterior spinal fusion is major surgery. Expect recovery to be a process commensurate with the procedure.

You will have been on an operating table for several hours, and opened in the front and back with internal plumbing temporarily pushed aside for access. Expect a bit of discomfort while you heal.

There will be some period when you are forbidden to lift anything heavier than a gallon of milk. Expect some inconvenience.

There will be a period of time when you are forbidden to take more than a flight of stairs in a single day. Return to work will be at the doctor’s discretion. And you will need to wear a brace for a while. Expect some limited mobility.

In this way, all major surgery is the same: The initial recovery period is the darkest, scariest, most frustrating, and most depressing time of the procedure.

While managing pain that seems like it will never end, you are relearning how to walk, eat, and perform functions you once took for granted.

This is the period when the doctor is telling you that everything looks great. But you feel like everything is broken, and will never get better. This is normal. Everyone goes through it to some degree.

It takes a while, but it does get better. Eventually, you will have a quality of life you didn’t dream possible. The details of recovery are much like the details of surgery. There is a time-honored process that will lead to a better life.

Other Considerations

It is important for your loved ones to know as much about what to expect from the procedure as you do. That is because they will be taking care of you while you recover.

Some relationships can be severely challenged due to the added stress of convalescence. Some of those stresses are financial. Even if insurance covers every penny of the surgery, you have to be prepared to be without your income until you can return to work.

If your line of work is what caused your issues leading up to surgery in the first place, you might have to consider a new line of work (if not early retirement).

This stress can be relieved by having some type of financial plan in place to deal with the possibility of lost income.

It might also be prudent to arrange some counseling during recovery, It is not unusual for patients recovering from major surgery to go through some situational depression due to lost mobility, income, and body image.

The best defense against these types of post-op stresses is knowledge. Consult your surgeon. Dr. Carl Spivak is a board-certified Neurosurgeon and President of Executive Spine Surgery P.P.C. He’s here to help you.

Get a realistic handle on the timetable. Learn about the procedure. Set yourself up for recovery success. And don’t try to go it alone. Involve family and friends, because love is always the best medicine.