Spine Surgery: An Overview

Spine surgery may be considered for certain disorders of the spine that lead to nerve compression or spinal instability. It can involve procedures such as decompression surgery, spinal fusion, or the insertion of artificial discs. Spine surgery is typically performed by a neurosurgeon or orthopedic surgeon, and is considered as a last resort after conservative treatment options have failed.

What are the different types of spine surgery?

There are many different types of spine surgery, and the appropriate type will depend on the specific condition being treated and the patient’s individual symptoms. Some of the most common types of spine surgery include:

  • Spinal fusion: This procedure is used to fuse two or more vertebrae together to reduce pain and improve stability in the spine. It is typically done to treat conditions such spondylolisthesis, scoliosis, and spinal fractures.
  • Laminectomy: This procedure is used to remove the lamina, a bony plate at the back of the vertebra, to relieve pressure on the spinal cord or nerve roots. It is typically done to treat conditions such as spinal stenosis and herniated discs.
  • Discectomy: This procedure is used to remove a damaged or herniated disc that is pressing on a nerve. It is typically done to treat conditions such as a herniated disc or degenerative disc disease.
  • Vertebroplasty and Kyphoplasty: These are minimally invasive procedures used to treat compression fractures in the spine by injecting cement into the affected vertebra to stabilize it. These are done to treat conditions such as osteoporosis, cancer, and trauma.
  • Artificial disc replacement: This procedure replaces the damaged disc with an artificial one to relieve pain and improve mobility. It is typically done to treat conditions such as degenerative disc disease.
  • Scoliosis surgery: This procedure is used to correct the abnormal curvature of the spine seen in scoliosis.

Open vs minimally invasive

Open spine surgery and minimally invasive spine surgery are two different approaches to performing spinal procedures. The choice between open and minimally invasive spine surgery will depend on the specific condition being treated, the patient’s individual anatomy and symptoms, as well as the surgeon experience and preference.

Open surgery

Open spine surgery typically involves a large incision, which allows the surgeon to access the spine directly. This approach is typically used for more complex procedures, such as spinal fusion or scoliosis surgery, and may require a longer recovery period. It is chosen when the condition needs a more direct and bigger access to the spine, like in case of tumors, severe scoliosis or severe trauma.

Minimally invasive

Minimally invasive spine surgery, on the other hand, uses smaller incisions and specialized instruments to access the spine. This approach is less invasive and typically results in less tissue damage, less blood loss, and a shorter recovery period. Minimally invasive techniques can be used for a variety of procedures, such as discectomy, laminectomy, and vertebroplasty. It is chosen when the condition can be treated with a smaller incision and less tissue disruption, like in case of herniated disc, spinal stenosis or degenerative disc disease.

When is surgery considered?

Spine surgery is typically considered as a last resort after conservative treatment options have failed. This means that before deciding to go for surgery, other non-surgical options will be tried first. These may include:

  • Physical therapy: Physical therapy can help to strengthen the muscles that support the spine, improve flexibility and reduce pain.
  • Medications: Pain medications and anti-inflammatory drugs can be used to reduce pain and inflammation.
  • Injections: Steroid injections can be used to reduce inflammation and pain.
  • Bracing: Certain spinal conditions such as scoliosis can be treated with a brace to help keep the spine in proper alignment.

These options will be tried for a period of time and if these don’t alleviate the symptoms or if the condition is severe, surgery will be considered. In some cases, surgery may be recommended as soon as the diagnosis is made, such as in case of tumors or severe trauma. The decision to move forward with surgery is usually made by the patient, in consultation with their doctor, after evaluating all the options and weighing the potential risks and benefits.

How effective is surgery?

Overall, the effectiveness of spine surgery can depend on the specific condition, the type of surgery performed, the surgeon experience and the individual patient’s characteristics. It’s important to have realistic expectations and to have a thorough discussion with the surgeon about the potential benefits and risks of the surgery, as well as the chances of success for your specific condition.

What is the recovery time?

The recovery time for spine surgery can vary depending on the specific type of surgery and the individual patient. In general, minimally invasive procedures have shorter recovery times compared to open surgery procedures.

For example, a minimally invasive discectomy, which is a procedure to remove a herniated disc, typically has a recovery time of several weeks, while a spinal fusion, which is an open surgery procedure, typically has a recovery time of several months.

Is surgery right for me?

Determining whether spine surgery is the right option for you will depend on your specific condition and symptoms, as well as your overall health and lifestyle. The best way to determine if spine surgery is right for you is to have a thorough discussion with your doctor or surgeon.

About the Author

Dave Harrison, MD

Dr. Harrison is a board certified Emergency Physician with a part time appointment at San Francisco General Medical Center and is an Assistant Clinical Professor-Volunteer at the UCSF School of Medicine. Dr. Harrison attended medical school at Tufts University and completed his Emergency Medicine residency at the University of Southern California. Dr. Harrison manages the editorial process for SpineInfo.com.