Types of back surgery
To relieve pressure on the spinal cord or nerves, surgeons can remove portions of bone to widen the narrowed area in the bones of your spine (vertebrae). Removing the gel-like middle portion of a ruptured disk also may help relieve pressure on pinched nerves. Sometimes your doctor has to remove the entire disk and fuse together the adjoining vertebrae that remain.
Different types of back surgery include:
- Diskectomy. This involves removal of the herniated portion of a disk to relieve irritation and inflammation of a nerve. It's done as an open surgery and typically involves full or partial removal of the back portion of a vertebra (lamina) to access the ruptured disk.
- Laminectomy. This procedure involves the removal of the bone overlying the spinal canal. It enlarges the spinal canal and is performed to relieve nerve pressure caused by spinal stenosis.
- Fusion. Spinal fusion permanently connects two or more bones in your spine. It can relieve pain by adding stability to a spinal fracture. It is occasionally used to eliminate painful motion between vertebrae that can result from a degenerated or injured disk.
- Vertebroplasty. During this procedure, your surgeon injects bone cement into compressed vertebrae. For fractured and compressed vertebrae, this procedure can help stabilize fractures and relieve pain. With a similar but more expensive procedure — called kyphoplasty — a balloon-like device is inserted to attempt to expand compressed vertebrae before bone cement is injected.
- Artificial disks. Implanted artificial disks are a treatment alternative to spinal fusion for painful movement between two vertebrae due to a degenerated or injured disk. These relatively new devices are still being studied, however, so it's not yet clear what role they might play as a back surgery option.
Consider all options
Before you agree to back surgery, consider getting a second opinion from a qualified spine specialist. Spine surgeons hold differing opinions about when to operate, what type of surgery to perform, and whether — for some spine conditions — surgery is warranted at all. Back and leg pain can be a complex issue that may require a team of health professionals to diagnose and treat.
Jul. 07, 2011
- Chou R. Subacute and chronic low back pain: Surgical treatment. http://www.uptodate.com/home/index.html. Accessed May 25, 2011.
- Hu SS, et al. Disorders, diseases & injuries of the spine. In: Skinner HB. Current Diagnosis & Treatment in Orthopedics. 4th ed. New York, N.Y.: The McGraw-Hill Companies; 2006. http://www.accessmedicine.com/content.aspx?aID=2319334. Accessed May 25, 2011.
- Evaluation of back pain. In: Goroll AH, et al. Primary Care Medicine: Office Evaluation and Management of the Adult Patient. 5th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008. http://gateway.ovid.com/ovidweb.cgi?T=JS&MODE=ovid&PAGE=main&D=baov&PCOSTART=goroll. Accessed May 26, 2011.
- Health care guideline: Adult low back pain. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/low_back_pain/adult_low_back_pain__8.html. Accessed May 31, 2011.
- Curlee PM. Other disorders of the spine. In: Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Mosby Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-4/0/1584/0.html. Accessed May 31, 2011.