Living with back pain can range from a bothersome nuisance to a painful interference with the activities you do every day. When back pain stops you from enjoying the things you love, you may begin to wonder if you need back surgery. Fortunately, there are many effective ways to treat your back pain, with a non-surgical approach.
Is back surgery right for me?
Together, you and your doctor will discuss what’s causing your back pain, previous treatment plans, your medical history and your goals for after surgery.
Your doctor may recommend surgery if:
- Back pain isn’t effectively managed with non-surgical treatments, including physical therapy, rest, cortisone injections and medication
- Pain is persistent and clearly caused by a mechanical problem in the spine
- You are in overall good health
- Surgery will help return you to most of the activities you enjoy
What types of back surgery procedures are available?
Today, there are many different options for back surgery, ranging from minimally invasive procedures to open back surgery. We offer many types of lumbar surgeries for our patients, including:
- Decompression surgery, including discetomy, laminotomy or laminectomy and foraminotomy
- Vertebroplasty or kyphoplasty procedures for spinal compression fractures
- Spinal fusion
- Disc replacement surgery
Decompression surgery
Decompression surgery is a common type of back surgery. It is often used to relieve pressure on the spine, which can be caused by many issues, including:
These conditions often cause the spinal cavity to narrow, which places pressure on the spine and nerves, resulting in back pain. Decompression surgery helps alleviate that pain by opening the spinal cavity back up. During surgery, your surgeon will remove a small portion of a piece of your spinal anatomy. There are three types of decompression surgery:
- Discectomy
- Laminectomy or laminontomy
- Foraminotomy
Discectomy
A discectomy removes part of a herniated or bulging disc that is putting pressure on the spinal cord or nearby nerves. It can be performed as an open discectomy or as a minimally invasive procedure called microdiscectomy. Sometimes, a laminectomy or laminontomy is performed at the same time.
Laminectomy or laminotomy
Both the laminectomy and a laminotomy create more space in your spine, which can be caused by bone growth or spurs. During a laminectomy or laminotomy, you will be placed under general anesthesia. In a laminectomy, the entire lamina around the affected vertebra is removed. The lamina is the plate the forms the outside walls around the vertebra. During a laminotomy, only part of the lamina is removed. This procedure helps increase the size of the spinal canal and relieves pressure in your back.
You will be placed under a general anesthesia for the procedure. Often, you are kept overnight for observation.
Foraminotomy
A foraminotomy is performed to expand nerve openings from the spinal cord. This procedure is most often done to address a pinched or compressed nerve. During the procedure, you will be placed under general anesthesia.
Your surgeon will make a small incision and use microscope-enabled tools to access your spine. Then, he or she will remove the bone or tissue that is obstructing the nerve passageways in your spine, called the neuroforamen . This procedure is sometimes performed at the same time as a laminectomy or spinal fusion.
Your recovery time will depend on the extent of your back pain and if any other procedures are performed during the foraminotomy.
Compression Fractures
Another common source of back pain is caused by compression fractures to the vertebra. Compression fractures can result from many different reasons, including osteoporosis, spondyliothesis or injury or trauma to spine. Oftentimes, patients can’t recall if or when they experienced a fall recently that could have caused the damage to their spine.
A compression fracture, while painful, can often be effectively treated. Rest, light physical therapy and a brace can help compression fractures heal. However, when pain is extreme and the fracture needs to be treated quickly, your doctor may recommend vertebroplasty or kyphoplasty to treat your compression fracture.
Vertebroplasty
Vertebroplasty is a minimally invasive outpatient procedure that helps stabilize compression fractures in the spine. Your doctor will use an X-ray to identify the location of the fracture in your spine, and then inject cement to fill the cracks in the affected vertebra.
A local anesthesia is used, and you are often able to go home the same day of the procedure. It is not recommended to drive yourself after the vertebroplasty, so plan on bringing someone to help you home. Bedrest is also recommended the first 24 hours, with a return to light activities over the next few days. Patients generally report a significant reduction in pain after the first 24-48 hours.
Kyphoplasty
Kyphoplasty is very similar to vertebroplasty. Your surgeon will inject cement into the fractures, gaps or cracks in your vertebra, but will also use a balloon-like device to add height back to the spine. During kyphoplasty, you may be placed under general anesthesia. You may also need to stay overnight for monitoring following the procedure.
Preparing for back surgery
Preparing for back surgery can seem like an overwhelming process. Spend a little time learning what you can expect before surgery and how you can get yourself on the road to recovery. Be sure to ask your doctor about any questions you have before surgery.
If your doctor has recommended surgery, it’s important to prepare before you arrive at the hospital. Spend time getting familiar with your procedure and learn how you can get on the road to recovery.