If a patient decides to proceed with surgery (the decision is theirs and they must give informed consent either personally or a parent on behalf of their child), they will eventually be given a date for admission to hospital. A delay of more than 4–6 months should not be tolerated. Ideally the time from GP referral to admission to hospital for surgery should be no longer than 3–4 months, but this is rarely achieved at present.

At operation the surgeon will monitor spinal cord function electronically, which is a useful safety measure. Sometimes he will use a so-called "wake up test" when the child is still anaesthetised and feeling no pain and is just conscious enough to move their feet to confirm normal spinal cord function. Once again, safety is a top priority. Serious complications such as paralysis are very rare (less than 1%). There is usually accommodation at the hospital for at least one parent who can be with the child. The parents' role is to reassure the child and to help and support the nursing staff and doctors who are caring for him or her. Al involved are on the same side trying to achieve a common objective of a happy and successful stay. Occasionally parents are overanxious and can even be untrusting of the staff, which helps no one.

The above description relates to posterior surgery (to the back of the spine). Sometimes it is more advantageous to operate on the front of the spine (anterior Surgery), to obtain a better correction with a shorter spinal fusion. This is particularly so for curvatures of the lumbar spine but sometimes other curvatures are best treated in this way. In anterior surgery access to the spine is obtained via one or more ribs. The rib when removed is used as bone graft between the vertebrae.  A system of screws and rods is usually used to correct the curvature and a high degree of correction can often be obtained. Nowadays anterior surgery is almost always safe and straightforward and your surgeon will discuss the details with you. The post-operative routine is much the same as for posterior surgery.

For both types of surgery it is essential that parents and patients should have as full an understanding as possible of the principles involved and the contribution they can make both before and after surgery . If everyone is working together, anxiety and stress are greatly reduced. Obviously, no major operation is without worry, and inevitably occasional complications arise, but a good understanding of what is involved helps all parties to work together for the best possible outcome.

The patient is usually in hospital for five to 10 days. Patients need to understand the principles of aftercare at home, which usually consists of gentle and gradual mobilisation with the child feeling more or less normal after about six weeks. Some calming influence by parents is usually necessary at that time because it takes three months for the bone graft to be reasonably secure. The child can usually return to school around two months after surgery, but no games, PE, or bicycle riding until three months, with all normal activities being resumed at 4-6 months, dependent on the advice of the surgeon. Outpatient follow-up appointments will usually take place 2–3 months after surgery and at 4–6 months, with check X-rays as necessary. Discharge from hospital care is about six months to one year after operation.