Aging, improper body mechanics, trauma and structural abnormalities can injure your spine, leading to back pain and other symptoms such as leg pain and/or numbness or even leg weakness.
The primary purpose of back surgery or neck surgery is to correct an anatomical lesion in individuals who fail to show improvement with conservative (nonsurgical) treatment. Surgery is not an option for patients when an anatomical lesion accounting for their pain can not be identified.
Surgery is only useful to change a patient’s anatomy (e.g. remove a disc herniation). There is almost never any reason to consider exploratory surgery to “look” for a cause of pain.
The most important factor in the determination of the success in spine surgery is proper preoperative diagnosis. Without an accurate preoperative diagnosis, even the most technically successful surgery has little chance for a successful outcome.
1. Decompress a nerve root or the spinal cord
2. Stabilize an unstable or painful segment with spinal fusion surgery
3. Reduce a deformity (e.g. scoliosis surgery in the thoracic spine)
Common surgical procedures
There are a number of conditions that may lead to spine surgery. Common procedures include:
- Discectomy or Microdiscectomy: Removal of a herniated intervertebral disc. Therefore, removing pressure from the compressed nerve. Microdiscectomy is a MISS procedure.
- Laminectomy: In this procedure, a surgeon removes parts of the bone, bone spurs, or ligaments in your back. This relieves pressure on spinal nerves and can ease pain or weakness. It can make your spine less stable. If that happens, you’ll probably need a spinal fusion. Doctors sometimes do the two procedures together.
- Laminotomy: Removal of a portion of the vertebral arch (lamina) that covers the spinal cord. A laminotomy removes less bone than a laminectomy.
Both laminectomy and laminotomy are decompression procedures. “Decompression” usually means tissuecompressing a spinal nerve is removed.
- Foraminotomy: Removal of bone or tissue at/in the passageway (called the neuroforamen) where nerve roots branch off the spinal cord and exit the spinal column.
- Disc replacement: As an alternative to fusion, the injured disc is replaced with an artificial one.
- Spinal fusion: This is the most common surgery for back pain. The doctor will join spinal bones, called vertebrae, together. This limits the motion between them and how far your nerves can stretch. But it probably won’t limit your activity. It’s rare, but the bones don’t always fuse completely. A surgical technique used to join two vertebrae. Spinal fusion may include the use of bone graft with or without instrumentation (eg, rods, screws). There are different types of bone graft, such as your own bone (autograft) and donor bone (allograft). A fusion can be accomplished by different approaches: