What Can You Expect From An Orthopedic Back Pain Surgery

Although the idea of surgery for your back pain can be terrifying, there are times when surgery may be the only option that makes you feel better.

It’s important to bear in mind that your doctor won’t recommend surgery unless it’s a last resort.

When is back surgery necessary?

If previous treatments have failed to offer you effective pain relief, back surgery may help. There are different types of back surgeries, with some being non-invasive. Various medical advancements have helped  make back surgeries less painful and recovery times faster.

Here’s when to know if surgery is the right option for you and what you can expect from these procedures.

Let’s start with signs that you should see an orthopedic surgeon for your pain.

10 Signs You Might Need Surgery For Back Pain

Patient Talking With Doctor

When you visit an orthopedic surgeon, they will not rush into recommending surgery unless you have an emergency condition.

Rather, they’ll want to see if other treatments can help relieve your symptoms first.

Here are some signs you might be a candidate for back pain surgery.

  • You have a herniated disc and it’s not getting better with other treatments
  • You have a tumor on your spinal cord
  • You have bone spurs in your back and they’re putting a strain on your spinal cord
  • You’ve got a spinal infection with symptoms such as a fever along with back pain
  • Your pain is severe and constant
  • You’ve got spinal nerve problems that are causing you to lose control of your bladder or bowels
  • You’ve broken a bone in your back
  • Your back pain is accompanied by weakness, numbness, or pain in your limbs
  • You’re having trouble using your limbs, such as difficulty with walking
  • You’ve got a spinal condition that’s getting progressively worse, such as spinal stenosis (narrowing of the spinal canal)

Four Common Types Of Back Surgery

There are different types of back surgery, depending on your condition or problem. Here’s a rundown of four of the main types.

Discectomy

This is sometimes referred to as a herniated disc surgery.

It can be performed to relieve pain caused by a compressed nerve, eliminate leg weakness or numbness, and to relieve the strain that’s put on the spinal nerves or spinal cord.

Your surgeon will make an incision over your spine and dissect down on the spinal canal. They will remove a section of the herniated disc that’s pushing on the spinal cord or nerve root and causing your pain.

This will also eliminate other symptoms that could be caused by the herniated disc, such as weakness, balance problems, numbness, coordination, and mobility issues.

There are two types of discectomies.

  • Open discectomy. This is when the surgery is done through an incision in your neck or back.
  • Microdiscectomy. This procedure is done with a smaller cut through which the surgeon inserts a thin tube with a camera on one end. This enables the surgeon to view and remove the damaged disc. Sometimes a laser can be used during this procedure to carefully and cleanly remove just the herniated portion of the disc.

What To Expect During A Discectomy

You will usually be put under general anesthesia during a discectomy. The surgeon will remove ligament and a bit of spinal bone in order to view and access the herniated disc.

The section of the herniated disc that’s been bulging out will be removed. Your surgeon will be careful to remove just the herniated portion of the disc and not damage any surrounding nerves or other tissues.

If too much of the disc and bone has to be removed a fusion will be considered too.

After The Surgery

You might be able to go home the same day of your surgery and recovery usually takes between two and six weeks to get back to normal activities.

You should avoid heavy lifting for up to eight weeks. Avoiding further injury to your discs and spine is vital and your doctor might suggest that you engage in low-impact exercises.

If you’re overweight, you might have to go on a weight-loss program to lessen the stress on your spine.

Laminectomy

This procedure is to a discectomy and they are often done together.

Your surgeon might recommend a laminectomy if you have bone spurs surrounding the spinal canal.

The lamina is the part of the spinal canal that works like a cover over the spinal cord. The surgery starts similar to a discectomy with an incision and dissection over the spinal canal. Bone is then exposed and trimmed to open space for the nerve roots to exit the spine.

By creating more space nerve compression is relieved.

Laminectomies are often done in combination with other spine surgeries to allow better visualization of the spinal canal, discs, and nerves.

What To Expect During Laminectomy Surgery

Just as with a discectomy you will be put under general anesthesia and an incision will be made on your back.

If you have a herniated disc, the surgeon will perform the laminectomy and will also remove the disc material that’s causing problems. Sometimes a spinal fusion will be combined with this procedure.

As with a discectomy, a laminectomy can under some circumstances be performed through a smaller incision with the use of a camera.

After The Laminectomy

Most patients go home the same day if they have just a laminectomy, but you might need to stay in the hospital for a short while.

You can go back to your normal life within a few weeks, but your recovery will last longer if you have other procedures with the laminectomy, such as a fusion.

Your doctor might also suggest that you go for physical therapy to help you regain your strength.

Spinal Fusion

Spinal fusion is usually reserved for when the other less significant surgeries cannot address the full problem.

This is the case if you have severe scoliosis or degenerative arthritis. This surgery for scoliosis (or spinal curvature) is usually a last resort treatment.

The surgery involves fusing two or more bones in the back, usually using some form of bone graft for support, either taken from your own body or some other form of graft.

The bones are held together with the use of metal rods and screws to align and stabilize the spine.

A traditional spinal fusion operation will consist of a large incision in the back, but the technology to perform a minimally invasive spinal fusion is now available.

In this procedure, the surgeon makes a small incision and uses special instruments and visualization through the incision to complete the operation with less damage to the surrounding soft tissues.

What To Expect During Spinal Fusion Surgery

You will be put under general anesthesia during this surgery.

The surgeon will make a cut in your neck, in your back, on either side of your spine, or in your abdomen, depending on where the vertebrae that require fusion are located.

If your own bone is being used for graft your surgeon will retrieve bone from your pelvis to make a bone graft. The discs and other soft tissues are removed and the vertebrae are fused together, with the bone graft placed between them.

Rods and metal screws used to add greater stability and help you heal.

After The Surgery

You might have to stay in the hospital for several days as this procedure tends to last longer and be more painful. Once you go home, you’ll probably have to wear a back brace to allow your spine to heal in alignment.

This also helps the bones to fuse properly, a process that can take at least six months.

You’ll probably also have to go to physical therapy to learn how to move in a way that maintains correct posture and spinal alignment.

Vertebroplasty and Kyphoplasty

Both of these are spinal operations that are used for spinal fractures and involve bone cement that is injected into a fractured vertebra. This helps to decrease compression that can lead to back pain.

Vertebral compression fractures are when the body starts to collapse onto itself and creating a wedge-shaped vertebra. Sometimes more than one vertebrae can be involved, resulting in a hunched over spine known as kyphosis.

Vertebral body fractures can occur for a variety of reasons. They are frequently the result of serious injuries, such as a car accident or a fall from a great height.

These fractures also commonly occur in older people with osteoporosis or weakening of the bone. For these older people with weak bone, spine fractures can occur with little or no trauma.

Here’s what to expect from both surgeries.

Vertebroplasty

A needle penetrates the skin and goes into the fractured vertebra. Then, bone cement is injected into the bone that’s been fractured.

Kyphoplasty

This also makes use of a needle and cement, but a balloon is inserted and inflated to increase the compressed vertebrae back to its normal size before the cement is injected into space.

This helps to prevent the back from hunching over into kyphosis.

What To Expect From Surgery

You can be given either general anesthesia or conscious sedation. Conscious sedation means you are given medicine so you don’t feel pain but you are still awake and you usually don’t remember the procedure.

After The Surgery

You will probably have to stay in the hospital for the night after your surgery just so that you can be observed. Then you’ll be allowed to go home.

For the next few weeks, you’ll have to be careful not to overexert yourself. For two weeks, you should avoid any bending or lifting, as well as any strenuous activity.

You might also have to see a physical therapist to help you learn the right way to move for better spinal alignment.

Although you might be tempted to rest a lot in order to recover, it’s actually advisable to begin walking as soon as your doctor allows it and then increase your activity as you feel you’re up to it.

For individuals with fractures due to osteoporosis this condition should also be addressed with appropriate medications or exercise.

Advancements In Back Pain Surgery

Drawing Surgery Lines

There have been many exciting advancements in back pain surgery over the last few decades.

These are changing how to back surgeries are performed by limiting tissue damage, decreasing pain, and reducing recovery time, making the process of having to go through back surgery much more comfortable.

Minimally Invasive Surgery

As mentioned earlier, some back surgery procedures now make use of minimally invasive technologies.

This means that instead of making a large incision on the back, surgeons reduce the size of the incision and the amount of trauma put on surrounding tissues. Specialized equipment and instruments are used to visualize the spine and perform the necessary procedures.

Having a smaller incision can also decrease the risks in some cases and cause less pain afterward.

Bone Graft Options

The use of bone grafts is sometimes used during back surgery, such as to help support fusions.

Sometimes these bone grafts are taken from the patient’s body, but they can also be sourced from cadavers or made synthetically.

Synthetic bone grafts have many benefits. They remove problems that can be associated with using bone from a donor, such as pain after the operation or the risk of infection.

Synthetic bone grafts are made from calcium and are sometimes referred to as ceramics.

They function similar to grafts taken from the patient or donors. However because they are made synthetically they are available in large quantities.

Synthetic Disc Replacements

Synthetic Disc Replacement

One of the most interesting medical advancements in back pain surgery involves the use of a synthetic disc replacement. These could even be used to replace spinal fusion surgery in the future.

The use of artificial mechanical discs to replace one’s biological discs has been adopted in Europe and is now being done in the United States also.

Spinal Navigation Technology

Computer-assisted image-guidance technology makes use of computers and x-ray technology to allow surgeons to better see the spine during the procedure.

This technology can offer the surgeon a variety of different displays, such as 3D scans, throughout all of the stages of surgery.

This can make surgery more successful by assisting in the safer placement of implants. For instance when placing spinal screws – their length and other measurements can be done with much more precision – and the correct planning for incisions and dissection.

A great feature of this technology is that surgeons can plan back pain surgery on the computer before the surgery begins in real life.

In addition, the use of this technology means that the patient and medical team are less exposed to radiation during the procedure because less x-rays need to be taken.

Long-Acting Local Anesthetic Instead Of General Anesthesia 

Giving Local Spine Anesthetic

While it might sound scary to stay awake during back surgery, this is proving to reduce recovery time in patients.

A traditional spinal fusion surgery that’s performed under general anesthesia can take about four hours and the patient requires IV painkillers afterward and a several day stay in the hospital.

By comparison, being awake during the surgery means it can be done in less time and patients will have less pain and will not need to stay in the hospital as long.

This surgery is performed under a type of local anesthesia known as liposomal bupivacaine.

It’s a long-acting anesthetic that’s recently been approved by the U.S. Food and Drug Administration (FDA).

This medication is injected into the lower back before the surgeon makes the incision for the procedure.

It lessens the need for IV painkillers after the surgery because this anesthetic provides pain relief for up to 72 hours. 

Related Questions

Is bed rest the most important thing after back surgery?

Bed rest is important for a very short time after your surgery but you should get up and move around as soon as possible. Your doctor will probably want you to start physical therapy soon after the operation.

Range of motion exercises will also help to strengthen your limbs and you’ll be encouraged to walk on a daily basis.

Why is walking good for you to do after back surgery?

Walking is a gentle exercise that provides many benefits. It boosts blood circulation, bringing nutrients and oxygen to the site of healing, thus increasing your recovery.

Walking is also a good exercise during back pain surgery recovery because it allows you to remain upright.

Conclusion

Hearing that you need to have back surgery may sound like both a blessing and a curse simultaneously.

On the one hand, you want to relieve your back pain if other treatments haven’t worked. But, on the other hand, you’re probably worried about what the back surgery will entail.

The good news is that back pain surgery is largely successful, whether the surgery is recommended for disease or structural problems.

While it’s not always a magical cure for pain, when doctors recommend back surgery it’s because they think the benefits outweigh the risks.

And, with technological advancements in medicine, the idea of spine surgery is becoming less frightening.

Common types of back pain surgery can relieve your symptoms and don’t require long recovery times, so you’ll be back to your normal activities soon.

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