Medical Oncologist
CION Cancer Clinics
Spinal stabilisation with rods and screws when cancer weakens the spine | CION Cancer Clinics
Rods and screws hold a spine steady when cancer has weakened the bone so much that it can no longer bear weight safely. They protect the spinal cord from bones that could shift, and they usually ease pain that worsens when you sit up or turn. This page explains how fixation works, what recovery and living with the metal involve, the risks, and who it does not suit. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Why would a spine with cancer need rods and screws?
- What kinds of fixation might your surgeon discuss?
- What happens in the days and weeks after fixation?
- Living with metal in the spine
- Four things families believe about rods and screws, and what is true
- What are the risks, and what can this page not tell you?
- Common questions about spinal rods and screws
The short answer
Why would a spine with cancer need rods and screws?
Rods and screws hold a spine steady when cancer has weakened the bone so much that it can no longer bear weight safely. They act like scaffolding. They protect the spinal cord from bones that could shift, and they usually ease pain that gets worse when you sit up, stand or turn.
What the metal actually does
Screws go into the healthy vertebrae above and below the damaged one. Two rods then join the screws on each side, bridging the weak section. Your body weight passes through the metal instead of the crumbling bone. Sometimes bone cement is added around the screws, because bone affected by cancer or by thinning can be too soft to grip them well.
Why it is so often done with decompression
When a surgeon removes tumour and bone to free the spinal cord, the spine loses even more of its support. Fixing it with rods and screws in the same operation stops it collapsing afterwards. Some people need fixation alone, without any decompression, because the bone is unstable but nothing is yet pressing on the cord.
Radiotherapy can shrink the tumour, but it cannot give back the strength the bone has lost. That is the job the metal does.How it is done
What kinds of fixation might your surgeon discuss?
The choice depends on how much bone is damaged, how many levels are involved and how fit you are. Ask which one is planned, and why.
Open fixation from the back
A cut down the middle of the back lets the surgeon see the bones directly and place the screws and rods. It is the usual choice when decompression is being done at the same time.
Screws through small cuts
Screws and rods are passed through several short cuts using X-ray guidance, without opening the muscles fully. It can mean less blood loss and a quicker start to radiotherapy.
Tends to suit
- An unstable spine with no pressure on the cord
- People less fit for a large open operation
Cement-strengthened screws
Bone cement is injected through or around the screws so that they hold in soft bone. It is often considered in older people and where cancer has thinned the bone widely.
Rebuilding the front of the spine
When the weight-bearing block of a vertebra has been destroyed, it may be replaced with a metal cage or cement, as well as rods at the back. This is a larger operation.
Whether any of these is available depends on your centre. Ask them directly.Not sure whether this applies to you?
Ask an oncologistAfterwards
What happens in the days and weeks after fixation?
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The first night
Usually in a high-dependency or intensive care bed. Nurses check leg movement and feeling often, and you will have regular pain relief. A drain from the wound and a urine catheter are common.
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Sitting and standing
Because the metal is holding the spine, a physiotherapist usually helps you sit up and stand within a day or two. Early movement lowers the chance of clots and chest infection.
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Going home
When you can move safely, manage the toilet and your pain is controlled on tablets. Some people need a short rehabilitation stay first. You will be shown how to get in and out of bed safely.
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Radiotherapy to the area
Usually planned once the wound has healed, to treat the tumour cells left in the bone. The metal does not stop radiotherapy being given.
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Check X-rays and follow-up
X-rays are taken at follow-up visits to make sure the screws have stayed in place. New pain, weakness or a clicking feeling in the back should be reported the same day.
Day to day
Living with metal in the spine
The worry
What usually happens
Can I have MRI scans in future?
Usually yes, though the metal blurs the picture near it. Tell the scan team
Will it set off airport security?
It may. Carry a letter or your discharge summary
Will I feel the rods?
Most people do not, though thin people may feel them under the skin
Does the metal come out later?
Almost never. It is meant to stay
Can I bend and sit cross-legged?
The fixed levels will not bend. Ask your physiotherapist what is safe
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Commonly believed
Four things families believe about rods and screws, and what is true
"With rods in his back he will never bend or work again."
Only the fixed section stops bending. The rest of the spine, the hips and the neck still move. Many people return to light daily activity. What is realistic depends on the cancer and on strength before the operation, so ask the physiotherapist.
"Screws will push the cancer into the rest of the body."
Placing screws does not spread the cancer. The screws go into healthier bone above and below the tumour, and the cancer is treated afterwards with radiotherapy and medicines.
"A belt or brace would do the same job without an operation."
A brace can support a spine that is only mildly weakened, and it is sometimes the right choice. It cannot hold a vertebra that is collapsing, and it does not protect the cord from bone that shifts inside the body.
"Once the spine is fixed, the cancer treatment is finished."
Fixation deals with the weak bone. It does nothing to the tumour. Radiotherapy to the area and treatment for the cancer elsewhere carry on as planned.
Did you know
Most spinal implants are made of titanium, which is usually safe in an MRI scanner. Some centres use carbon-fibre implants, which blur scans and radiotherapy planning less. If this matters for your follow-up, ask your surgeon which kind they use.
Being straight with you
What are the risks, and what can this page not tell you?
Spinal fixation is a large operation, often in people already unwell from cancer. Your surgeon should explain the risks that apply to you, and it is reasonable to ask how often they happen at that centre.
Problems that can happen
Wound infection or slow healing, especially where radiotherapy has already been given. Bleeding. Blood clots and chest infection. Nerve injury from a screw, which is uncommon but can cause new weakness or numbness. Screws can loosen or the rods can break later, particularly if the bone around them stays soft or the cancer grows.
Who it tends not to suit
People too unwell for a long anaesthetic, people with cancer at many levels of the spine where there is no healthy bone to anchor screws, and people whose cancer is widespread and not responding. For them, a brace, radiotherapy and pain control are usually discussed instead.
What this page cannot tell you
It cannot tell you whether you or your parent should have the operation, or how much pain will ease. That rests on the scans and on an examination, and it belongs to your treating team.
Questions we are asked
Common questions about spinal rods and screws
How do they know the spine is unstable enough to need fixing?
They look at the MRI and CT for collapse, the position of the tumour in the bone, and whether the bones are out of line. They also ask how the pain behaves. Pain that is much worse on sitting up, standing or turning over, and better lying still, is a strong clue.
Will the screws loosen over time?
They can, especially in soft bone or if the cancer grows around them. That is why check X-rays are taken at follow-up. Most people never have a problem, but tell the team the same day about new pain, a clicking feeling or new weakness.
Can radiotherapy be given with the metal in place?
Yes. Radiotherapy to the operated area is routine once the wound has healed. The metal makes planning a little more careful, because it affects how the scans used for planning look, but it does not stop treatment.
Will I need a brace as well as the rods?
Sometimes, for extra support while the wound heals or where the bone is very soft. Many people do not need one. Your surgeon will say before the operation, and the physiotherapist will show you how to put it on and take it off.
Can the rods be used if my mother has thin bones?
Often yes. Cement can be used to strengthen the grip of the screws in soft bone, and more levels may be included to share the load. Very thin bone does make fixation harder, so ask the surgeon how it changes the plan for her.
What about blood thinners before the operation?
Tell the team about every medicine, including aspirin, clopidogrel, warfarin and newer blood thinners. The surgeon, anaesthetist and the doctor who prescribed them decide whether and when any are paused and restarted. Do not stop or change them on your own.
Is fixation done if the cancer is very advanced?
Sometimes, when pain from an unstable spine is severe and the person is fit enough to recover from the operation. At other times a brace and radiotherapy are kinder. This is a decision to make with the team, weighing comfort and time in hospital, and there is no single right answer.
Is spinal fixation covered by Aarogyasri or insurance?
Often, as part of an approved cancer treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted at CION, and most cashless insurers are empanelled. Implants may be billed separately, so ask for a written estimate that includes them, and call the helpline to check your cover.
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Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
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Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- NICE — Spinal metastases and metastatic spinal cord compression (NG234)
- Macmillan Cancer Support — Spinal cord compression
- American Cancer Society — Bone metastases
- Cancer Research UK — Surgery for cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Decompression Surgery for Spinal MetastasesThe operation that frees the cord, usually done alongside fixationVertebroplasty and Kyphoplasty for Spinal PainCement injections for a painful vertebra without rodsBracing and Mobility After Spine SurgeryBraces, moving safely and what to avoidSpine Surgery Cost in HyderabadIndicative ranges, implants and what schemes coverMedicines Around Cancer SurgeryBlood thinners and other medicines before an operation
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Told the spine is unstable?
Send us the scan report or call the helpline. A surgical oncologist will go through the options with you. One helpline serves every CION centre.