Concierge spinal surgery · UK
Spinal Fusion - when the right operation, done properly.
Fusion is not the default for back pain. It is the right operation for instability, spondylolisthesis, scoliosis and failed prior surgery. A consultant spinal surgeon, motion-preserving options considered first, and a full recovery plan.
Why patients choose us
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A consultant spinal surgeon, high-volume in fusion
Fusion is one of the most technically demanding operations in spine surgery. We only route to consultants doing multi-level fusion regularly.
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Fusion only when the alternatives have run out
Decompression, disc replacement, physio and injections considered honestly first. Fusion is the last tool, not the first.
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Independent, and free
We are paid by no clinic, so the recommendation - fusion, disc replacement, or another route - is impartial and costs you nothing.
Indicative pricing
What spinal fusion costs privately in the UK.
Indicative ranges across our spinal network. Send the details and we quote firm figures across the appropriate options.
In short
A single-level lumbar fusion in our network: £22,000–£38,000, 2–4 nights in hospital.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Consultant spinal surgeon consultation | £300–£500 | 30–45 min | Report in 3 working days |
| MRI + dynamic X-rays | £600–£1,100 | 45 min | Report 24–48 h |
| Single-level lumbar fusion (TLIF/PLIF) | £22,000–£38,000 | 2–4 hours | 2–4 nights |
| Anterior lumbar fusion (ALIF) | £24,000–£42,000 | 2–4 hours | 2–4 nights |
| Lateral lumbar fusion (XLIF/OLIF) | £25,000–£42,000 | 2–4 hours | 2–4 nights |
| Multi-level lumbar fusion | £38,000–£75,000 | 4–8 hours | 4–7 nights |
| Scoliosis / deformity correction | £65,000–£140,000 | 6–10 hours | 5–10 nights |
Prices vary by hospital, by consultant, by number of levels and by implant cost (cages, screws, biologics). Multi-level fusion and complex deformity correction sit at the top of the range. We come back with a firm quote within one working day.
The problem
The right diagnosis, the right level, the right operation.
Fusion is overused for isolated back pain and underused for genuine instability. We fix both errors before you consent.
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Instability, not just back pain
MRI plus dynamic X-rays - flexion and extension - to prove instability before recommending fusion.
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Motion-preserving first
Decompression alone, microdiscectomy, or disc replacement where possible. Fusion is the final tool, not the first.
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Adjacent-level disease is real
Fusing one level increases load on the neighbours. We plan around it - and consider disc replacement where suitable.
The journey
From enquiry to recovery - what happens, in order.
One spinal team from first message through workup, surgery and structured rehabilitation.
Phase 1 · Before
Assessment and planning
Phase 2 · Procedure
On the day
Phase 3 · After
Recovery and follow-up
- 01
Before
You tell us what is going on
A short confidential form. Symptoms, imaging so far, treatments tried, previous surgery, and what you want to be able to do.
- 02
Before
Consultant spinal surgeon review
Assessment against MRI, dynamic X-rays (flexion/extension), neurological exam. Motion-preserving options actively considered.
- 03
Before
Pre-op optimisation
DEXA if osteoporosis risk, smoking cessation (fusion in smokers has much lower success), weight and glycaemic optimisation.
- 04
Before
Options and consent
Written options with honest risks, expected outcomes, adjacent-level disease risk and hardware considerations.
- 05
On the day
Admission and surgery
GA in a licensed theatre. Single-level lumbar fusion 2–4 hours; multi-level or complex deformity longer.
- 06
On the day
Post-op recovery
Typically 2–4 nights in hospital for single-level lumbar, longer for cervical multi-level. Mobilised day 1 with physiotherapy.
- 07
After
Structured rehab and X-ray follow-up
Physio from week 2–3. X-rays at 6 weeks, 3, 6 and 12 months to confirm union. Return to full activity 3–6 months.
Typical end-to-end: 8–12 weeks from enquiry to surgery. Return to office work: 6–12 weeks. Bone union: 6–12 months.
When it helps
When fusion is the right step.
The situations we see most, plus the honest situation where fusion is not the answer.
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Spondylolisthesis with symptoms
A slipped vertebra causing back and/or leg pain, particularly with instability on dynamic X-rays.
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Scoliosis with progression or pain
Adult degenerative scoliosis with pain, disability or progressive curve. Deformity correction with fusion.
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Trauma with instability
Vertebral fracture with instability. Fusion stabilises to prevent neurological deterioration.
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Failed prior decompression
Instability that has developed after decompression alone - revision with fusion.
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Tumour or infection needing reconstruction
After spinal tumour excision or discitis, fusion may be needed to reconstruct stability.
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Severe DDD with proven instability
Rare, selected cases where degenerative disc disease is demonstrably unstable and non-operative treatment has failed.
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Cervical myelopathy with kyphosis
Cervical spinal cord compression with kyphotic deformity needing correction and stabilisation.
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When fusion is NOT the answer
Isolated axial back pain without radiological instability rarely improves with fusion. We say so honestly and explore other routes.
Techniques
Posterior, anterior, lateral, transforaminal - the approach fits the level.
What each approach involves - incision, technique, and which pathology it fits.
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Posterolateral fusion (PLF)
Bone graft laid alongside decorticated transverse processes and secured with pedicle screws. The classic technique.
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Transforaminal lumbar interbody fusion (TLIF)
Approach through the intervertebral foramen, cage inserted into the disc space plus posterior instrumentation. Workhorse for single-level fusion.
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Posterior lumbar interbody fusion (PLIF)
Bilateral posterior approach with two cages in the disc space. Older technique, still used in some situations.
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Anterior lumbar interbody fusion (ALIF)
Anterior abdominal approach directly onto the disc. Excellent for L5/S1 and where anterior column restoration is needed.
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Lateral lumbar interbody fusion (XLIF/OLIF)
Side approach through the psoas - muscle-sparing, single-level or multi-level. Good for L2–L4.
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Anterior cervical discectomy and fusion (ACDF)
Anterior neck approach - disc removed, cord decompressed, cage and plate for fusion. The standard cervical fusion.
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Posterior cervical fusion
For multi-level cervical myelopathy or fixed kyphosis. Lateral mass or pedicle screws with rods.
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Deformity correction
Multi-level fusion with osteotomies to correct scoliosis or kyphosis. Highest complexity, longest recovery, biggest life impact for the right patients.
Our vetted UK network
A small panel of consultant spinal surgeons, we picked them.
Consultant spinal surgeons (neurosurgical and orthopaedic) with fusion volume across London and the major UK cities. Introductions are made privately.
Selection criteria
How we choose every spinal surgeon in our network.
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Consultant spinal surgeons (neurosurgical or orthopaedic) with fellowship spinal training and high fusion volume
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Intra-operative imaging (fluoroscopy, O-arm) as standard for screw placement
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Named surgeon in every case - no team-list booking
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Structured post-operative physiotherapy pathway on site
Safety and recovery
What to expect afterwards - honestly.
Fusion is bigger surgery than decompression alone. What we plan around: bleeding, dural tear, hardware issues, non-union and adjacent-level disease.
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Bigger surgery than decompression alone
Longer operation, more blood loss (though usually not enough for transfusion), longer stay, longer recovery.
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Dural tear happens
1–5% depending on approach and revision status. Almost all repaired at the time.
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Screw misplacement is uncommon
With intra-operative imaging, screw misplacement causing nerve injury is well under 1%.
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Non-union (pseudarthrosis)
5–15% depending on levels, technique and patient factors. Smoking, obesity and diabetes increase risk substantially.
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Adjacent-level disease
The neighbouring level bears more load after fusion. 20–30% show radiological adjacent-level change at 10 years; symptomatic disease in a minority.
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Infection
Under 2% for elective single-level fusion; higher in revision and long deformity cases. Prompt washout and antibiotics if it occurs.
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Bleeding and transfusion
Multi-level and deformity surgery can need cell salvage or transfusion. Rare in single-level.
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Hardware pain
Some patients feel screws or rods and, once fusion is solid, hardware can be removed if it is genuinely the pain source.
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Red flags after surgery
New weakness, bladder change, spreading redness, fever, severe unrelieved pain or breathlessness need same-day review.
Reading your notes
Your operation note in four parts. Read the last one first.
Whatever the approach, the fusion note keeps to the same shape.
A quiet reminder
Clinical language is precise - we translate it if you would like.
If you would like us to talk you through your notes before your review, just ask.
- 01 Header
Indication, levels and approach
Why fusion, which levels, which approach used.
- 02 Technique
Instrumentation and biologics
Screws, rods, cages, bone graft and biologics used. Intra-operative imaging findings.
- 03 Findings
Intra-op findings and adjuncts
Instability confirmed, decompression performed, any incidental pathology.
- 04 Plan
Rehab, brace, X-ray schedule
Read this first: mobilisation, brace instructions (if any), driving and return-to-work timing, X-ray schedule to confirm union.
Recognised by major UK insurers
Spinal fusion is usually covered when medically indicated for instability, spondylolisthesis, scoliosis or trauma. Fusion for isolated axial back pain is often not covered without documented instability. We check cover before booking.
Frequently asked
Everything patients ask about spinal fusion.
Quick answers on when fusion helps, recovery, hardware and adjacent-level disease.
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Is spinal fusion the right operation for my back pain?
For pure axial back pain without radiological instability, honestly usually no. Fusion works best for instability, spondylolisthesis, scoliosis and failed prior surgery - where it addresses a specific mechanical problem. We are open about this in every consultation, and often recommend continuing physio, injections or a decompression-only operation instead.
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What is the difference between TLIF, PLIF, ALIF and XLIF?
They are different approaches to the same goal - fusing two vertebrae with a cage and screws. TLIF and PLIF are posterior, ALIF is anterior (through the abdomen), and XLIF is lateral (through the flank). The approach depends on which level is being operated on, what needs to be decompressed, and previous surgery.
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How much does spinal fusion cost privately in the UK?
Single-level lumbar fusion runs £22,000–£38,000, multi-level £38,000–£75,000, and scoliosis correction £65,000–£140,000. Cervical fusion (ACDF) runs £13,000–£22,000. We confirm firm figures within one working day and check insurance cover.
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How long is recovery after lumbar fusion?
Most patients stay 2–4 nights in hospital, are off strong painkillers within 2–3 weeks, back to office work in 6–12 weeks, and to full activity in 3–6 months. Bone union takes 6–12 months on X-ray. Structured physiotherapy is essential, and smoking prevents union - non-negotiable.
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What is adjacent-level disease and should I worry about it?
When you fuse two vertebrae, the neighbouring levels bear more mechanical load. About 20–30% show radiological adjacent-level change at 10 years, but only a minority develop symptoms needing further treatment. It is one reason motion-preserving techniques (like disc replacement) are chosen where possible.
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Will I set off airport metal detectors?
Modern implants (titanium) rarely set off airport detectors, though enhanced scanners may pick them up. A wallet-sized implant card is standard - we issue one at discharge. MRI is safe with modern implants; specific device details are in your operation note.
Related treatments
Looking for something else?
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Discectomy
Motion-preserving disc surgery.
Learn more -
Lumbar spinal decompression
Decompression without fusion.
Learn more -
Minimally invasive spinal surgery
Small-incision techniques across the spine.
Learn more -
Excision of spinal tumour
Where reconstruction with fusion is often needed.
Learn more -
Physiotherapy for back pain and sciatica
First-line for most back pain.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more