Spinal Fusion Surgery

Spinal fusion is surgery that joins two or more vertebrae so they move as one solid unit. Think of it like bridging a wobbly section of the spine to stop painful motion and protect nerves.

The surgeon reaches the problem level from the back, front, or side of your spine, clears space around the nerves if needed, and prepares the bone surfaces so they’ll grow together. Bone graft (your own bone, donor bone, or a bone‑substitute) is placed between the vertebrae, often inside a spacer cage. Metal screws and rods (or plates) hold everything steady while new bone grows across the gap.

Why do it? Fusion is used for problems caused by instability or deformity, such as a slipped vertebra (spondylolisthesis), certain fractures, spinal deformities like scoliosis, or painful disc collapse and arthritis that keep irritating nearby nerves. Unlike a disc replacement, fusion sacrifices motion at that level to gain stability and relieve nerve pressure. Surgeons choose the approach (posterior, anterior, lateral) and the specific technique (TLIF, PLIF, ALIF, LLIF) based on your anatomy, the exact problem, and which route offers the safest, most direct path to stabilize the spine.

Shorter wait times

• Canadians waiting for spinal surgeries face some of the longest wait times—often a year or more.
• Private centres can coordinate assessment and surgery in weeks, not months—reducing time spent with nerve pain, weakness, or mobility limits.

Choice and control

• Pick a high‑volume spine surgeon (orthopedic or neurosurgeon) with the exact approach you need (TLIF/PLIF/ALIF/LLIF).
• Choose clinic location (including out‑of‑province) and schedule around exams, work, caregiving, or sport seasons.
• Get a clear, personalized plan: need for decompression, levels to fuse, bone graft options, and bracing.

Peace of mind

• You know who’s operating, the date, and the strategy (approach, hardware, length of stay). Direct communication and quick responses help plan time off, travel, and physiotherapy.

Preventing further decline

• Function: Ongoing instability or nerve compression can mean worsening pain, numbness/weakness, and lost endurance.
• Anatomy: Progressive slippage or deformity can become harder to correct later and may require larger operations.
• Performance: Faster relief helps protect school/work productivity and mental health.

Integrated care

• Access to advanced imaging, navigation/robotics, and neuromonitoring in accredited facilities.
• Coordinated teams (anaesthesia, pain, physio) and, when needed, combined deformity or revision expertise.

1. ‍Confirm the diagnosis. Most patients start with a family doctor or specialist who confirms that spinal fusion surgery is advisable, but your surgeon can also confirm if needed.
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2. Research. Explore surgeons who specialize spinal fusion surgery.
   
   • You can find surgeon in Vancouver, British Columbia; Calgary, Alberta; Toronto, Ontario; and Montréal, Québec on our app, and review qualifications, as well as pricing.
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3. ‍Schedule an initial consultation. Most surgeons offer in-clinic and online consults.
   
   • Consultations are usually booked within days or a few weeks.
   • Note: expect a consultation fee between $150 - $350.
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4. ‍Consultation. The surgeon will review your condition, symptoms, and any previous treatments or diagnostics, such as x-rays or MRIs.
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5. ‍Post consultation. The surgeon will then review your case and provide surgical options based on your needs; review the risks and expected outcomes; and present pricing and scheduling options.
   
   • Because the procedure is not covered by your provincial health plan when done privately, you’ll need to review the quoted cost and consider payment options (out-of-pocket, private insurance, or financing).
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6. ‍Schedule your surgery date. Once you confirm the procedure and payment, the clinic will schedule your surgery—generally within a few weeks.
   
   • Plan for travel and accommodation, since the surgery will likely take place outside your home province.
   • Expect pre-surgery preparation, and possibly some pre-surgery tests.

Spinal fusion surgery times vary considerably depending on the procedure (single-level lumbar fusion, lateral fusion, multi-level fusion, anterior lumbar fusion), ranging between 2 and 6+ hours.

Add extra time at the centre for check‑in, anaesthesia, and recovery. Some cases stay overnight or a few days.

Basic steps (what actually happens)

Check‑in and marking

• You meet the team, confirm levels to fuse, and review the plan. The skin is marked.

Anaesthesia

• General anaesthesia (you’re fully asleep). Lines and monitors are placed; many centres use nerve monitoring.

Position and prep

• You’re positioned safely (on your back, side, or stomach depending on approach). The skin is cleaned and sterile drapes are placed. X‑ray/fluoroscopy is set up for precise level targeting.

Access (approach)

• Posterior (from the back: TLIF/PLIF), anterior (from the abdomen: ALIF), or lateral (from the side: LLIF). Small to moderate incisions are made; muscles are gently moved aside.

Decompression (if needed)

• The surgeon removes pressure on nerves (laminotomy/laminectomy/foraminotomy) and clears out any herniated disc or bone spurs.

Prepare the disc space

• The damaged disc material is removed. The endplates are prepared to accept a spacer (cage) and bone graft.

Place cage and bone graft

• A spacer filled with bone graft (your bone, donor bone, or bone substitute) is inserted to restore height and alignment.

Screws and rods/plate

• Pedicle screws and rods (posterior) or a plate (anterior) are placed to hold everything steady while the bone grows and fuses.

Rinse and check

• The area is irrigated. Alignment and hardware position are confirmed with X‑ray. Bleeding points are sealed.

Close up

• Layers are closed with sutures. A dressing is applied; sometimes a small drain is used.

Wake‑up and instructions

• You recover in PACU, get pain and walking plans, and transfer to the ward or go home based on your case and surgeon’s protocol.

Every spine is different—follow your surgeon’s plan. Steady, consistent progress beats pushing too hard.

In general, what to expect

Week 0–1

• Reality check: back soreness, muscle spasms, stiffness, and low energy. Getting in/out of bed is awkward.
• Goals: protect the fusion, control pain, walk safely.
• Activities: short, frequent walks (hallway laps), deep breathing, gentle ankle pumps. Keep the dressing clean/dry. Learn log‑rolling to get in/out of bed without twisting. No bending, lifting, or twisting (BLT).

Weeks 2–4

• Still annoying but improving.
• Goals: build a walking habit, improve posture and core activation (without sit‑ups), manage swelling/bruising.
• Activities: daily walks increasing time/distance, gentle nerve glides if prescribed, light self‑care tasks at counter height. Stitches or staples removed if needed. Some people start a brace‑wean per surgeon advice.

Weeks 5–12

• The work phase.
• Goals: steady endurance, basic core control, safer movement patterns.
• Activities: longer walks, stationary bike (upright) if cleared, gentle hip/leg strengthening, basic spine‑neutral core work (breathing, pelvic tilts, isometrics). Still no heavy lifting or twisting. Desk/school work is common; manual work waits.

Months 3–6

• Rebuild strength and confidence.
• Goals: return to most daily activities; gradual fitness.
• Activities: progress lower‑body and core strength, light upper‑body work close to the body, pool walking if allowed. Some start structured physio for movement quality and pacing. Avoid high‑impact and heavy lifts until cleared.

Months 6–12

• “Normal‑ish” for many single‑level fusions.
• Goals: full daily function; sport/work‑specific training.
• Activities: add impact/rotation and heavier loads only with explicit clearance. Focus on hip mobility, glute strength, and spine‑neutral mechanics to protect adjacent levels.

Red flags—call your care team

• Fever, spreading redness, or foul drainage from the incision
• New/worsening leg pain, numbness, or weakness
• Loss of bladder/bowel control
• Calf pain/swelling, chest pain, or shortness of breath

Milestones and X‑rays vary by case (level, approach, bone quality). Your surgeon will set the pace for driving, return to school/work, and lifting limits.

Spinal fusion is a major surgery, and the costs vary drastically depending on levels fused (one vs multiple), approach (TLIF/PLIF/ALIF/LLIF), whether decompression is added, implant choices, length of stay, and surgeon/centre experience. Always ask for a written, itemized quote.

In Canada, private clinics charge: $25,000 - $75,000+ for spinal fusion surgery. However, in multi-level cases with large deformities, costs can exceed $100,000.

In the United States, costs range between CA$90,000 to CA$200,000+.

What’s usually included

• Surgeon fee (orthopaedic or neurosurgeon) and anaesthesia services
• Accredited facility/OR time, nursing, standard disposables
• Implants for a typical case (screws/rods/cage/plate) as specified in the quote
• Intra‑op imaging (fluoroscopy) and basic neuromonitoring if bundled
• Immediate recovery care (PACU) and early follow‑up visit(s) within the “global” period
• Basic pathology if any tissue is sent

What’s often not included

• Initial consults and pre‑op imaging/labs (MRI/CT, X‑rays) done outside the clinic
• Advanced tech add‑ons: navigation/robotics fees, extensive neuromonitoring, biologics (BMP) unless explicitly bundled
• Extra levels, longer OR time beyond the booked block, or conversion to inpatient with additional nights
• Separate specialist fees (e.g., vascular access surgeon for ALIF)
• Prescriptions after discharge (pain meds, anti‑nausea, stool softeners)
• Post‑op physiotherapy beyond the first visits; bracing if required
• Travel and accommodation if you’re out‑of‑province/state

Tips to compare quotes

• Ask if it’s a global bundle and request line items: surgeon, facility, anaesthesia, implants (with brand/quantities), neuromonitoring, navigation/robotics, and follow‑ups.
• Clarify pricing triggers: added levels, decompression, unexpected admission, or hardware upgrades.
• Confirm what follow‑ups are included and whether virtual visits are available if you live far away.

Choosing your surgeon is a major benefit of pursuing private surgery, here's how to choose wisely.

What to look for

Experience and volume

• Ask how many spinal fusions they perform per year, and their case mix: single‑level vs multi‑level, revisions, deformity (scoliosis/kyphosis), trauma, cervical vs lumbar, and approaches (TLIF/PLIF/ALIF/LLIF).
• Higher volume and routine pathways usually mean smoother care and fewer complications.

Credentials and training

• Verify licensure with your provincial college (CPSO Ontario, CPSBC BC, CPSA Alberta, CMQ Québec, etc.).
• Look for FRCSC‑certified orthopedic spine surgeons or neurosurgeons with fellowship training in spine surgery.

Outcomes and safety

• Request recent data: infection rate, blood transfusion rate, dural tear, nerve injury, unplanned return to OR within 30–90 days, readmissions, and re‑operation for non‑union/hardware issues.
• Ask for patient‑reported outcomes (leg/arm pain reduction, disability scores), return‑to‑work timelines, and fusion (union) rates on follow‑up imaging.

Indications and alternatives

• Ensure non‑operative options were tried or appropriately considered (targeted physio, injections, medications, bracing). Clear indications = better odds of meeting expectations.

Surgical plan and techniques

• Which levels and why? Need for decompression? Chosen approach (posterior TLIF/PLIF, anterior ALIF, lateral LLIF) and rationale.
• Implant choices (screws/rods/cage), bone graft options (your bone, donor, BMP/biologics), and neuromonitoring/navigation or robotics use.
• How they minimise blood loss, infection, and adjacent‑level stress.

Imaging and planning

• How pre‑op X‑rays, MRI/CT, and standing alignment films guide level selection, alignment goals, and approach.
• For deformity/revision, ask how they plan sagittal balance and hardware strategy.

Facility accreditation

• Confirm the hospital/clinic is accredited (Accreditation Canada/CAAASF or provincial program), with ICU/back‑up, neuromonitoring, and a transfer agreement if outpatient.

Rehab integration

• Written, phased recovery plan; brace policy; realistic timelines for walking, desk work, heavy labour, and sport.
• Coordination with local physiotherapy if you’re travelling; clear red‑flag instructions and direct post‑op contact.

Pricing transparency

• Itemized quote: surgeon, facility, anaesthesia, implants (brand/quantities), neuromonitoring, navigation/robotics, imaging, length of stay, and included follow‑ups.
• Clarify add‑on charges for extra levels, longer OR time, second surgeon (e.g., vascular for ALIF), or unexpected admission.

Questions to ask during your spinal fusion consultation

Surgeon and plan

• How many of this exact fusion (levels + approach) do you perform yearly?
• What are your last 12–24 month rates for infection, transfusion, dural tear, nerve injury, readmission, non‑union, and re‑operation?
• Which levels will you fuse and why? Do I also need decompression?

Technique and safety

• Which approach (TLIF/PLIF/ALIF/LLIF) are you recommending and why for me?
• What implants and bone graft will you use? Do you use neuromonitoring and navigation/robotics?
• How do you reduce blood loss, infection, and blood‑clot risk?

Recovery and after‑care

• Expected timeline for walking, driving, school/desk work, manual work, and exercise?
• What bending/lifting/twisting limits will I have, and for how long? Will I wear a brace?
• What red flags should trigger a call/ER visit? Who is my direct post‑op contact? How many follow‑ups are included and when?

Costs and logistics

• What exactly is included in the quote (surgeon, anaesthesia, facility, implants, neuromonitoring, navigation, imaging, stay, first follow‑ups)?
• What could add cost (extra levels, longer OR time, second surgeon, inpatient nights)?
• If plans change mid‑surgery (e.g., need additional level), how do you handle consent and pricing?

Signals of a high‑quality program

• Shares outcomes and complication rates openly, including fusion (union) data.
• Provides a clear, written recovery plan and coordinates with your local physio.
• Operates in accredited facilities with appropriate tech and multidisciplinary support.
• Offers transparent, itemised pricing with clear inclusions/exclusions and responsive post‑op communication.