What type of spine surgery is right for me?

By Scott Sanderson, MD, Chief of Neurosurgery, Danbury Hospital, part of Nuvance Health

We know you want relief fast when back or neck problems cause pain and make it difficult for you to do daily activities. If you have tried non-surgical treatments such as anti-inflammatory medication and physical therapy without relief, spine surgery may be an option.

Spine surgery can help relieve neck or back problems that are degenerative and do not get better from non-surgical treatments. The kind of spine surgery that may be right for you depends on the type, location and symptoms as well as your age, other medical conditions, personal preferences and lifestyle.

Here are common spine conditions and types of surgeries to treat them.

Learn more about back and spine surgery at Nuvance Health Neuroscience Institute.

The most common spine conditions that surgery can help

Spinal disc problems

Spinal discs are between each vertebra in the spine. They are rubbery on the outside with a jellylike inside. A herniated disc — also called a bulging, slipped or ruptured disc — happens when a disc is compressed (squished) and presses on the spinal cord and nerves. 

Related content: Woman with cancer bounces back after two spine surgeries for herniated disc and bone spur

A herniated disc is one of the most common causes of arm, neck, back and leg pain. It can happen to anyone at any age from an injury, like a vehicle accident or lifting something heavy. It can also occur without a specific reason.

A herniated disc can cause nerve pain, and in turn, numbness, tingling or weakness in the arms or legs and limit mobility. Some people may refer to the pain as a pinched nerve, or sciatica if it is specific to the leg.

Related content: Know when to get spine treatment for back and neck pain

Spinal stenosis

Spinal stenosis is a narrowing of the spinal column, which can put pressure on the nerves and cause pain. Spinal stenosis is most common in people age 50 and older and is caused by osteoarthritis — the most common form of arthritis.

The most common types of surgery for spine conditions

Nuvance Health spine specialists aim for minimally invasive surgical options as much as possible because people go home sooner after surgery and heal faster. People used to stay in the hospital for several days and then go to an inpatient rehabilitation facility after spine surgery. Now, most people can go home from the hospital the same day, or within a day or two after spine surgery.

Related article: Do these five things before your first visit with a surgeon for spine pain

Cervical disc replacement

Artificial disc replacement may be an option to treat a herniated disc in the cervical spine (neck). During the operation, the surgeon makes a small incision in the front of the neck to access the front of the cervical spine. They then remove damaged disc portions or the entire disc and replace it with an artificial disc.

Artificial disc replacement may be a good option for younger people with overall healthy discs and minimal neck arthritis. It usually helps relieve arm and shoulder blade symptoms caused by the herniated disc and associated nerve pain. Most people regain full range of motion and can resume their typical activities, even including recreational sports like golf and tennis.

Cervical discectomy fusion

Discectomy and fusion is the alternative to artificial disc replacement in the neck. The operation and outcome are similar to artificial disc replacement, except the surgeon fuses together the vertebrae above and below the herniated disc and pinched nerves.

Discectomy and fusion may be a good option for:

Laminectomy

Laminectomy is a common spinal stenosis treatment. During the operation, the surgeon removes all or part of the back part of the bone that covers the spinal canal (lamina) to make space and decompress the spinal cord and bundle of nerves.

Laminectomy is a great operation that has been around for many years. Traditionally, laminectomy has been an open surgery. Today, we can offer minimally invasive techniques through small incisions. Most people tolerate the surgery well and get relief from pain in the arms, buttocks or legs.

Microdiscectomy

Microdiscectomy is a common treatment for a herniated disc in the lower back (lumbar spine). During this minimally invasive procedure, the surgeon removes pieces of the herniated disc to relieve pressure on the nerves, and subsequently improve the pain, numbness or weakness associated with the pinched nerves that travel into the buttocks and legs. This procedure may be good for people who do not need spinal fusion or hardware to stabilize the spine.

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Spinal fusion

Spinal fusion for a herniated disc or stenosis is a combination of decompression and then stabilization. During the procedure, the surgeon will repair the damaged disc, or remove the arthritis pinching the nerves in the spine and then fuse the vertebrae together.

Spinal fusion may be good for people who need more stability in their spine, whether from age-related or traumatic injuries, loss of stability from the decompression itself, or to adequately free up the nerves.

Many people cringe at the thought of a spinal fusion because the traditional techniques have led to long and painful recoveries. Surgeons at Nuvance Health use robotic-assisted techniques for spinal fusion. We strive to design the least invasive surgery to accomplish our operative goals, and work closely with people to educate them on all of their options.

Total Posterior Spine Surgery

Total Posterior Spine Surgery (TOPS™) is an alternative to spinal fusion surgery for certain people with stenosis and spondylolisthesis in the lower back. Like spinal fusion, TOPS can improve the debilitating symptoms of these back problems and stabilize the spine. TOPS is different than a fusion because it can maintain a normal range of motion in the back without fusing the bones of the spine together. Learn more about TOPS for spinal stenosis and spondylolisthesis.

The bottom line: There are many types of spine problems and surgeries. Your surgeon will recommend spine surgery based on the type of injury and other factors like your age and lifestyle. Remember, it is okay to ask questions and develop a surgical plan with your surgeon that is best for you.