28 days after


  • Your child should continue to work on returning to a normal schedule. We encourage your child to perform all of his/her daily activities (i.e., shower, get dressed) and light activities to get their strength and endurance back.
  • Most patients do not need physical therapy. Shoulder blade stiffness is normal.
  • Begin schoolwork (continue with a tutor).
  • Plan a return-to-school date. Many will start part time and transition to full time over 1-2 weeks.
  • Consider use of an elevator if needed.

We do not recommend:

  • Heavy back packs. We recommend two sets of school books for the year: one at school and one at home.
  • Gym class right away. Speak to your child's teacher about your future gym class and activity modifications.
  • Driving a car or riding anything with wheels until your child is off all narcotic pain medications and he/she has full neck and back motion (usually six weeks after surgery).


  • Ensure your child is eating a high fiber, high iron, nutritious diet. Consider supplementing with a multivitamin with iron, especially for girls.
  • Continue to drink at least 64 ounces of water per day.
  • When returning to school, send water and snacks with your child.

Wound care

  • Your child's scar heals for a year. While your child will always have a scar, the pink color will slowly fade to more the color of his/her skin.
  • Protect the healing scar from the sun by putting clothing over the scar, a bandage over the scar, high SPF over 15 applied every hour, or Zinc oxide on the scar when it is exposed to the sun.
  • If your child chooses to use scar healing creams, we do not recommend using them until six weeks after the procedure.

Future precautions

Dental precautions

  • Tell your child's dentist or orthodontist (oral surgeon) about the spinal surgery. It is important that the dentist or oral surgeon know about any hardware applied to your child's spine.
  • During the first years after surgery, your child will need to take an antibiotic just before a visit to the dentist or orthodontist for teeth cleaning or any dental procedures. The antibiotic needs to be taken one hour before the visit. Talk to your child's healthcare provider if your child must go to the dentist and an antibiotic is needed.

Tattoos or body piercings

  • Avoid tattoos or body piercings for at least one year. There is an increased risk of infection due to the implants.


  • Smoking is never recommended. There are additional risks with exposure to smoke after surgery.
  • Being around someone who is smoking can delay wound healing after surgery. It also can lead to an increased risk the spine not fusing. This can lead to an increased chance that the rods will break.


  • In general, we do not recommend the use of trampolines after a spine fusion.