Spinal surgery is performed thousands of times each year in the United States, yet it’s unique from other surgeries in that there must be a specific problem involving the spine or supporting joints and discs identified before it’s considered. When surgery does become a possible source of lasting relief, there are many techniques and procedures available; and just as many factors to consider when making your decision. Here’s what you need to know about spinal surgery.
When to Consider Spinal Surgery
Back surgery may be an option worth considering if you are not experiencing meaningful relief with non-surgical treatments. Go-to remedies typically include temperature therapy (application of heat or ice), passive and active forms of physical therapy, and the use of various anti-inflammatory and pain medications. Spinal surgery may also be worth considering if:
- Your pain is becoming progressively worse or new symptoms are appearing
- Persistent discomfort (six months or more) is affecting your quality of life
- Spine pain is related to compression or inflammation affecting nerve roots (radicular pain)
Achieving an Accurate Diagnosis
Spinal surgery is more likely to be successful if your back or neck pain has been accurately diagnosed. It’s a process that often involves a process of elimination through testing and description of symptoms. X-rays will provide information on the various bones and joints of the spine while MRIs will identify possible problems with soft tissues. CT scans provide cross-section images of individual vertebra and indicate whether or not there is a reduction in spinal space (spinal stenosis) that may be contributing to your pain.
Common Types of Spinal Surgery
There are three basic types of spinal surgery that are often performed to address some type of structural problem involving the spine. Fusion surgery is the most common of these procedures.
Spinal fusion is a two-step operation that involves the removal of a damaged disc or the correction of an abnormality with the spine. The purpose of the surgery is to join, or “fuse,” two adjacent vertebra together to restore stability of the spine. The lack of mobility in the affected area also helps minimize discomfort. The second part of the procedure is the application of bone graft material. Special hardware is installed to stabilize the spine until the fusion forms.
A discectomy involves the removal of part or all of a damaged spinal disc in order to relieve pressure on nerves. If spinal stability is affected by the removal of the disc, a fusion may be performed at the same time.
When a laminectomy is performed, part of the back part a bone covering the spinal column (lamina) is removed. As with a discectomy, it’s done to ease pressure on nerve roots.
What to Expect After Spinal Surgery
Following some initial rest immediately after the procedure, you will likely be encouraged to take steps to increase your mobility and restore muscle strength. For most patients, it’s a process that involves a customized physical therapy plan based on individual capabilities and goals. Full recovery from most spine surgeries will take several months.
Less Invasive Surgery Techniques
A growing approach with spinal surgery is to use surgical methods that are less invasive. Such techniques include making smaller incisions and using specialized tools, cameras, and lighting systems. With spinal fusion alone, there are three minimally invasive surgery systems that are being used during more surgeries of this nature, including one involving an interbody fusion performed through tubes.
Increasingly common minimally invasive procedures include an endoscopic discectomy that involves the remove of protruding disc material through small incisions. Spinal fractures may be corrected with an injection of bone cement (vertebroplasty) or with the use of a special balloon (kyphoplasty).
For many procedures, the surgeon is guided during the operation with a live X-ray (advanced fluoroscopy). When minimally invasive spinal surgery is performed, patients often experience:
- Fewer risks and complications
- Less blood loss during surgery
- Faster healing and recovery times
There’s rarely an urgency to have spinal surgery unless symptoms are severe. In most cases, you’ll have time to weigh your options and consider other non-surgical options before making a decision. For common procedures like spinal fusion and decompression, the success rate is fairly high; although it’s just as important to have realistic expectations of what the outcome may be before having surgery. Making positive lifestyle changes with diet and exercise after surgery can also improve your odds of enjoying beneficial results.