After Scoliosis Surgery: Children and Teens

The big picture

Scoliosis surgery is a big operation, and teenagers recover from it remarkably well. The pattern is predictable: a hard first few days, a turning point around the end of the first week, and steady gains every week after that. By six weeks most teens are back at school full time and feeling close to normal. By three to six months most are back to their sports. This playbook covers posterior spinal fusion and vertebral body tethering; where they differ, it says so.

In the hospital

• The first night is spent in a monitored unit. Pain is controlled with a combination of medicines, often including a nerve-blocking medicine placed during surgery and a patient-controlled pump for the first day.
• Your child sits up and stands with the therapists on the first day and walks by the second. It looks hard, and it is the single most useful thing they can do.
• A bladder catheter and sometimes a drain are removed on the first or second day. After tethering, a small chest tube drains the lung space for a day or two.
• Eating starts slowly. The bowel is slow after this surgery, and a bowel plan starts right away.
• Most children go home in three to five days, when they are walking, eating, and comfortable on pills.

The first two weeks at home

• Pain: expect the worst to be behind you by the end of week one, with sore muscles and stiffness for a few more weeks. Scheduled acetaminophen is the base. Opioid tablets are tapered over about one to two weeks, and I want them finished by the two-week visit for most patients. A muscle relaxant at bedtime helps. Ibuprofen is allowed after tethering; after a fusion, no anti-inflammatories for three months.
• Sleep: broken sleep for one to two weeks is normal. A flat, firm mattress, log-rolling to turn, and a pillow between the knees help. Nightmares and tearfulness are common for a few nights after anesthesia and pass.
• Appetite: often poor for the first week, with a sensitive stomach. Small frequent meals, fluids, and a daily stool softener until opioids are finished. Call if there is no bowel movement by day four, or any vomiting with a swollen belly.
• The incision: keep the dressing dry for two to three days. Then a shower is fine, letting water run over the closed incision and patting it dry. Leave glue or strips to fall off on their own. No baths, pools, or tubs for six weeks. Send us a photo at 2 weeks.
• Walking: several short walks a day, building to 20 to 30 minutes by the end of week two. Stairs are fine.
• No bending, lifting more than a backpack's worth, or twisting for six weeks. No brace is needed after a modern fusion or a tether.

School, screens, and friends

• School: most return part time at two to three weeks and full time by four to six weeks, often with a second set of books, an elevator pass, and permission to stand or walk during long classes. We provide the letters.
• Screens and phones: fine, but keep the neck and shoulders moving and change position often.
• Friends: visits lift the mood and the recovery. A short walk with a friend is better medicine than a long afternoon on the couch.

Sports and activity

• Weeks 0 to 6: walking only.
• Week 6 visit: X-rays. After tethering, most restrictions are lifted and running, gym, and non-contact sports begin. After fusion, swimming, cycling, and running begin; a physical therapist may help with core strength and posture.
• Three months after fusion: most non-contact sports.
• Six months after fusion, if the X-rays show the fusion forming: contact sports and gymnastics, case by case. After tethering, there are generally no long-term sport restrictions.

What is normal

• Numb patches of skin around the incision that shrink over months.
• A ridge or small bumps along the incision that flatten by a year.
• Feeling taller, and finding that clothes fit differently: the trunk is longer and straighter.
• A new awareness of the shoulders or hips being "even," which can feel odd for a few weeks.
• Mood dips in weeks two and three, when the hardest part is over but normal life has not fully returned. It is common, and it passes. Tell us if it does not.

Your follow-up

• 2 weeks: incision photo, or a wound check if stitches need removal.
• 6 weeks: visit with X-rays. Most restrictions reviewed.
• 3 months, 6 months, 1 year, 2 years, then periodically until growth is finished and beyond. After tethering, visits are closer together while your child is still growing, because the correction continues to change.

Call the office the same day for

• Fever over 101.5°F, or spreading redness, drainage, or an opening in the incision, at any point in the first year. A late infection can appear months after surgery; take any drainage seriously.
• Pain that is getting worse after the first week, or new leg pain.
• No bowel movement by day four, vomiting, or a swollen, hard belly.
• Calf pain or one swollen leg.
• A headache that is much worse upright and better lying flat.

Call 911 or go to an emergency room for

• New weakness or numbness in the legs, or trouble walking.
• Loss of bladder or bowel control.
• Chest pain or sudden shortness of breath.

Learn more

Scoliosis Research Society, Surgical treatment and recovery: srs.org (opens in a new tab)

Pediatric Orthopaedic Society of North America, Scoliosis: orthokids.org (opens in a new tab)

More for families

OrthoKids · POSNA

POSNA's OrthoKids: illustrated, family-friendly information on this condition.

Open on OrthoKids (opens in a new tab)

Scan for the OrthoKids page

This playbook is general guidance for Dr. Wey's patients and their families. Your own discharge instructions come first. If anything here does not match what you were told, what you were told wins: please ask us.