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The Kinds of Back Surgery

Nearly everyone will suffer from back pain at some time during their life. The degree of back pain can range from mild to so painful that it is disabling. The National Institute of Health says nearly 90 percent of back pain sufferers won't require any treatment. Approximately 5 percent of people have chronic and debilitating back problems. Back surgery is generally performed only in these severe cases when non-invasive measures have been unsuccessful.

  1. Who Should Consider Back Surgery?

    • According to the NIH, two groups of people need surgery to correct their spinal problems. People in one group suffer chronic low back pain and sciatica (leg pain), and they are frequently found to have a herniated (ruptured) disk, spinal stenosis, spondylolisthesis, or vertebral fractures with nerve involvement.

      The main issue for those in the other group is a condition called discogenic low back pain (degenerative disc disease) that tends to strike as people age.

    Diskectomy & Microdiscectomy

    • A diskectomy consists of the removal of the herniated portion of a disk to ease irritation and inflammation of a nerve. This type of surgery usually involves full or partial removal of the back portion of a vertebra (lamina) to gain entry to the ruptured disk.

      As with conventional diskectomy, a microdiscectomy consists of removing a herniated disk or damaged portion of a disc through an incision point in the back. It differs from a diskectomy because the incision is significantly smaller and the surgeon must use a magnifying microscope to find the disk through the incision. In addition to reducing pain, the microdiscetomy may lessen tissue disruption and leave a smaller surgical scar.

    Laminectomy

    • During a laminectomy, the bone overlying the spinal canal is removed. This procedure enlarges the spinal canal and is conducted to alleviate nerve pressure that results from spinal stenosis.

      When a laminectomy/diskectomy is performed, part of the lamina (a section of bone on the back of the vertebrae) is removed along with a portion of a ligament. The herniated disk is then taken out through the incision.

    Fusion

    • Spinal fusion permanently connects two or more bones in your spine using bone grafts, screws, and rods to prevent slippage of the impaired vertebrae. Bone used for grafting comes from another part of the body such as the pelvis or hips. It can ease pain by strengthening a spinal fracture.

    Vertebroplasty

    • During a vertebroplasty operation, the surgeon injects bone cement into compressed vertebrae that may be the result of trauma or osteoporosis. This procedure can help stabilize fractures and lessen pain.

      A similar but more costly operation called kyphoplasty inserts a balloon-type device as a means to expand compressed vertebrae before bone cement is injected.

    Artificial Disks

    • Implanted artificial disks are fairly new devices that may be used as an alternative to spinal fusion for painful movement between two vertebrae that is caused by a degenerated or injured disk.

    Laser Surgery

    • Laser surgery is sometimes used on patients with herniated disks who suffer from lower back and leg pain. The surgeon inserts a needle in the disk that sends a brief rush of laser energy to vaporize the disc tissue. This decreases its size and lightens pressure on the nerves.

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