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How long will the incision be, and what can I expect in terms of scarring?

Dr. Robert W. Molinari

Rochester, NY

The incision is usually the length of the curvature. Incisions are typically closed using plastic surgery techniques to minimize scarring.

Dr. John T. Smith

University of Utah Department of Orthopaedic Surgery

An incision for surgery through the back is made down the center of the spine. This is usually a fairly well healing incision, but it does leave a noticeable scar. Some patients use Vitamin E and other substances to reduce scarring. Some patients have found this to be helpful. When the surgery is done from the front (via an anterior approach), the incision is typically made over one of the ribs and extends toward the middle of the abdomen. This produces a more visible scar.

Dr. Baron S. Lonner

New York, NY

The approach and the number and extent of the curvatures that are treated determine the length of the incision. For example, a thoracic curvature treated from a posterior (back) approach will require an incision approximately six to eight inches long. If this curve is approached through an anterior approach, endoscopically, then several one-inch incisions under the arm are used and are well hidden by a bathing suit and the arm. Double curves approached from the back require an incision that extends a greater length of the spine. Closures of incisions are done with plastic surgery suture techniques with dissolvable sutures that result in minimal scarring.

Dr. Christopher L. Hamill

Buffalo, NY
Buffalo General Hospital

The incision depends on the fusion levels and the scars are usually fairly cosmetic.

Dr. Thomas G. Lowe

Woodridge Orthopaedics & Spine Center, P.C.

Anterior instrumentation can now be utilized approximately 50% of the time. The incision usually not longer than approximately 6.0 inches and is on the side of the rib cage or abdomen where the arm usually covers it so that only a small portion of the incision is visible. If the surgery requires posterior instrumentation and fusion, which is in that back, the incision likely will need to be somewhat longer, especially if more than one curve requires surgical treatment. The scarring now is very minimal. Stitches are usually underneath the skin and dissolve. The skin is closed with paper tape and generally leaves very little scarring.

Dr. Scott J. Luhmann

St. Louis, MO

For open procedures, the incision will be made directly down the middle of the back or over the flank. Endoscopic procedures can be performed through a series of smaller incisions over the area of the spine to be treated. A plastic surgery-style closure is performed with all of the sutures being under the skin, so no sutures have to be removed after surgery. The sutures gradually dissolve under the skin and are absorbed by the body.

Dr. W. Christopher Urban

Glen Burnie, MD

The length of the scar depends on the nature of the curve and the number of levels to be fused. It can range from a few inches to the length of the back. Fortunately, the incision is in the midline of the back and usually heals very well. Surgeons can use absorbable stitches that do not have to be removed and form less scar tissue. Limiting exposure of the incision to the sun during the first six months also helps to reduce scar visibility.

Dr. Robert S. Pashman

Los Angeles, CA

Any time an incision is made in the skin, a scar is produced. With careful attention to technique in closing the skin, though, the scars can be minimized. Using a traditional open approach, the length of the incision correlates almost exactly with the number of vertebrae that have to be fused. Using modern endoscopic techniques, multiple one- to two-inch incisions are made at the point where the camera and instruments are introduced into the body.

Dr. John P. Lubicky

Chicago, IL
Shriner's Hospital for Children

First of all, the length and shape of the incision depends on whether the surgery is being done from the back or the front. If it is being done from the back, there will be a single straight scar down the middle of the back. If it is done from the side in the traditional manner, there will be a curved incision over the side of the chest over the ribs. For surgery that is done through the scope, there will be multiple smaller incisions along the side over the ribs. The amount of scarring depends on how the individual's body reacts to the incision. Some people, particularly those who have dark skin, tend to scar more and may develop what are called keloids, which are raised areas of healing skin along the incision. Generally speaking, fair-skinned people do not scar as much. However, the wounds are generally closed with plastic surgery technique with buried suture that does not have to be removed, and generally the scars are pretty narrow and not very noticeable.

Dr. Frank J. Schwab

New York, NY

The length of the surgical incision depends upon the levels and type of scoliosis. A number of curves can be corrected through incisions on the side of the body (for anterior surgery) with incisions that are 6-8 inches long. For curves that are corrected through a posterior approach (in the back), the incisions are usually 8-12 inches long. Some very stiff curves that in the past may have required anterior and posterior surgery can be partially treated with endoscopic surgery minimizing the anterior scars to a few 1-inch incisions. The appearance of the scar after scoliosis surgery is very dependant upon how your body heals. In most people the scars heal very well and are barely noticeable.

Dr. Charles E. Johnston, II

Texas Scottish Rite Hospital Orthopedic Group

The posterior incision length depends on whether you have one two or three curves to be corrected, and can extend from the upper shoulder blade area to just above the gluteal crease. A well-healed scar usually ends up as a thin white line within a year of the operation.

Dr. David W. Polly, Jr.

Minneapolis, MN

The length of the scar depends on the length of your curve. Most of the time the surgery is done from the back and the scar is in the middle of the back. Sometimes we do the surgery through the side and then the scar is on the side. The width of the scar depends on the individual. Some people are "keloid" forms are can end up with a wide scar. If you have had a cut or previous surgery and you formed a keloid, then you may form one again.

Dr. James Mooney, III

Detroit, MI

The incision will cover the extent of the area fused and may be quite long. The scar itself should be fairly thin and not prominent.

Dr. Dennis G. Crandall

Mesa, AZ

The incision will be as long as the area requiring correction. In some cases it can extend from between the shoulder blades down to the low back. Though long, the scar is usually very thin.

Dr. Jean-Pierre C. Farcy

New York, NY
M.M.C. Spine Center

The length of the incision varies with the amount of vertebrae to include in the fusion, it can go from the top of the back to the waist line or even lower down. In some case a second scar over the pelvis in the back may be left by the incision made for harvesting the bone graft from the iliac crest. If a surgical decision was made to treat your scoliosis by anterior surgery you will have an incision following one of your ribs on one side, the length of which may vary from 10 to 15 inches. If the surgery was performed through endoscopy there will be four small incisions of 1.5 inches each. The scars may be bluish at first and become white and thinner usually in a year's time.

Dr. Stephen Ondra

Chicago, IL

The incision can either be on the back of the spine or on the side of the ribcage. When the incision is on the side of the ribcage, it is typically about 8-10 inches long. When it is on the back, it will typically extend from just below the top of the shoulders to the end of the ribs. This incision length will of course vary with the type of scoliosis and areas of curvature that you have. In general, the incision will run over the entire length of the fixed spinal curvature when done from the back.

Dr. Patrick Bosch

Albuquerque, NM

For posterior spinal fusion surgery, the incision is made along the posterior midline (middle of the back) over all levels of the spine to be fused. The incision usually heals well, with minimal widening. But, all people heal differently. A scar often will “mature” over the first 6-8 months, which means it may get redder or more raised before it “smoothes itself out.”

The commentary above recounts the experiences of these physicians. Medtronic invited them to share their stories candidly. Keep in mind that results vary; not every patient's response is the same. Talk with your doctor to learn more about any products that are mentioned above.

It is important that you discuss the potential risks, complications and benefits of spinal surgery with your doctor prior to receiving treatment, and that you rely on your doctor's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.

  • Published: June 20, 2002
  • Updated: July 10, 2008