Got back pain questions? Our Back Wellness Coaches have answers. Text Us Now at 412.419.2225. It's FREE!

Which Back Surgery Option is Right for You?

October 2, 2017

Are you wondering which surgery is right for you? Backers, look no further. We accumulated a comprehensive list of the six most utilized surgeries for your back or spine condition. Let the learning commence.

Spinal Fusion

Doctor going over options for back surgery.Am I a Candidate?

If you just had surgery for your back pain and a follow-up after surgery is needed, your doctor may recommend a spinal fusion, which is done to treat problems such as spinal stenosis, herniated discs, injuries, infection, and tumors. Spinal fusion was originally done to treat fractures. Now, it is also used to manage age-related spinal issues as well as spinal stenosis.

How is it Performed?


Your surgeon would connect spinal bones — vertebrae — concurrently. Doing so restricts any movement within the vertebrae as well as how greatly your nerves can stretch.

Spinal fusion operation times range from about 2 ½ hours to 6 or 7 hours, infrequently even longer. The length of time depends on the quantity of vertebrae being fused, how severely the vertebrae are affected, whether or not any spinal nerves are pinched, the necessity of decompression on those nerves, in addition to if scarring exists from any prior surgeries. The goal of a spinal fusion is to prevent abnormal movement and therefore reduce any pain in your back and legs


Laminectomy

Am I a Candidate?


A laminectomy is often completed to treat spinal stenosis. Your doctor may recommend a laminectomy if other more conservative treatment methods, including medication or physical therapy, misses the mark on improving your symptoms. If you have muscle weakness or numbness that causes difficulty while standing or walking, you may need this operation in addition to loss of bowel or bladder control. In other cases, a laminectomy may be required as part of surgery to treat a herniated disc.

How is it Performed?


Laminectomy is a surgery that generates space in your back by eliminating the lamina, which is the back part of the vertebra that shields the spinal canal (think of the lamina as a disgruntle bodyguard who just got fired from his or her job and is being escorted out of the building). This surgery is also identified as decompression surgery. A laminectomy enlarges your spinal canal to remove (as best as possible), any pressure on your spinal cord and/or nerves.

The surgery necessitates a hospital stay from one to three days, recovery time ranges from four to six weeks, and the procedure can sometimes make your spine less stable. If that happens, you’ll need a spinal fusion (see above). Sometimes doctors do the two procedures concurrently. Nevertheless, the goal is to reduce tension on the spinal cord (or spinal nerve) by enlarging the spinal canal.

Foraminotomy

Am I a Candidate?

If you live with spinal stenosis, you may need to undergo a foraminotomy. Other severe symptoms that hinder your daily life may drive your surgeon to suggest this operation. Those symptoms include, pain felt in your thigh, calf, lower back, shoulder, arms or hands. The pain is usually deep and constant. In addition to pain when accomplishing particular activities, numbness, tingling, and/ or muscle weakness.

How is it Performed?

During a foraminotomy, a surgeon slices away bone at the sides of your vertebrae to widen the space where nerves exit your spine. The additional room helps to alleviate pressure on the nerves to ease your pain. Similar to a laminectomy, this procedure can also make your spine less stable. Therefore, the surgeon may do a spinal fusion at the same time, which would extend your recovery time.

Physical therapy may be suggested for the first few weeks following this operation. The complete recovery time is normally between two and three months. Luckily, a foraminotomy has been known to have very good success rates for reducing the symptoms of foraminal stenosis — the narrowing of the cervical disc space generated by amplification of a joint in the spinal canal.

The purpose of a foraminotomy is to eliminate as little tissue as possible in order to preserve the architectural integrity of the spine.


Discectomy

Am I a Candidate?


Receiving a herniated disc diagnosis may be cause for a discectomy. If you have extremely severe leg pain, numbness, or weakness that prevents you from being able to complete your daily pursuits; if your leg symptoms do not improve following at least 4 weeks of a nonsurgical treatment option, your surgeon may recommend this procedure. In addition, if results of a physical exam reveal that you have weakness or loss of motion, those symptoms should improve following surgery.

How is it Performed?


Sometimes a disc, the cushion that separates your vertebrae, can move out of place, put pressure on a spinal nerve and produce back pain. In a discectomy, the surgeon removes all or part of the disc. He or she may have to make a large (or small) incision in your back. There are instances when this surgery becomes part of a larger one that includes laminectomy, foraminotomy or spinal fusion.

This procedure usually takes one to two hours. However, it may be prolonged if you have scar tissue from prior surgeries. The goal of a discectomy is to relieve that pressure on your nerve roots within the neck by elimination of damaged tissue, herniated disc and/or abnormal bone growth.


Disc Replacement

Am I a Candidate?


Artificial disc replacement is meant to help relieve low back pain, however, not all patients with low back pain are candidates. Generally speaking, qualified candidates for disc replacement have certain characteristics.

Those characteristics include back pain caused by one or two problematical intervertebral discs in the lumbar spine, no notable facet joint diseases or bony compression on spinal nerves, body size that is not unreasonably overweight, no previous major surgeries on the lumbar spine, and zero deformities of the spine, a condition such as scoliosis.

How is it Performed?


A surgeon removes the damaged spinal disc and inserts an artificial one between your vertebrae. Unlike fusion, this lets you continue to move your spine. And, recovery time may be shorter than for a spinal fusion. But, there is a slight chance that the new disc could slip or fall out of place and require repair (such as another surgery).

In most circumstances, you will remain in the hospital for 1 to 3 days. The duration of your stay will depend on how much pain you feel post surgery in addition to your return to function. The goal of this procedure is to reduce your back pain whilst supporting a more normal motion than is provided with other procedures, such as a spinal fusion.


Interlaminar Implant

Am I a Candidate?


An interlaminar implant is normally designated for use in patients with one or two level lumbar stenosis from L1-L5 in skeletally mature cases who have mild impairments in function, who also endure symptoms of leg, buttocks, or groin pain, with or without back pain who have undergone at least 6 months of non-operative therapies. So if you have spinal stenosis and your symptoms do not improve, this implant may be an option for pain relief.

How is it Performed?


A surgeon would implant a U-shaped device between two vertebrae within your lower back. It helps to maintain space in between those vertebrae while eases pressure on your spinal nerves. It can be done at the same time as a laminectomy. But, unlike spinal fusion surgery, the implant affords you increased stability and allows you to move more freely (maybe how you felt before you experienced back pain, which is the ultimate goal).

Most patients are able to leave the hospital within 24–48 hours after surgery. Once your surgeon gives you the go to leave, you may require physical therapy. Your surgeon may also request a reduction in physical activities for the first six weeks after your operation.


Have you had any of the above operations? How did it go? We want to hear from you. Start a discussion to swap stories and interact today. 

Last change: October 2, 2017
New User?
Get FREE access to relevant knowledge, discussions and a community of experts and peers to help you overcome your back pain challenges.

Register