The type of back surgery you may need depends on what’s causing your back pain. Procedures that treat compression of the spinal cord, such as laminectomy and spinal fusion, are among the most common lower back surgeries.

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Back pain is common and has many different causes. According to a 2021 report, 39% of adults — and 45.6% of adults over 65 — experienced back pain in the last 3 months.

Lower back pain can often be eased with conservative methods such as nonsteroidal anti-inflammatory drugs (NSAIDs) or physical therapy. If your pain doesn’t respond to these treatments, or you have a back injury that could cause severe complications, you may need surgery.

Many types of surgery are used to treat lower back pain. The type of surgery you may need depends on what’s causing your back pain.

Let’s take a closer look at some of the most common surgeries for lower back pain.

Artificial disk replacement

Artificial disk replacement surgery is used to treat back pain caused by a damaged or worn out disk between the vertebrae (small bones in your spine). It involves replacing the damaged disk with an artificial one, while maintaining normal motion of your spine.

In a 2018 review, researchers reported:

  • satisfaction rates from 75.5% to 93.3%
  • complication rates from 0% to 34.4%
  • a reoperation rate of 12.1%

Spinal fusion

Spinal fusion is a procedure where a surgeon removes one or more disks from between your vertebrae and fuses your vertebrae together. This surgery limits the mobility of your spine in the area that’s fused together. It’s used to relieve back pain and other symptoms in people with spinal instability that’s caused by:

Most studies report success rates of spinal fusion for degenerative disk disease between 84% to 92%.

Spinal laminectomy

A spinal laminectomy is done to treat spinal stenosis, a condition where the spinal cord or nerve roots are compressed by the vertebral bones. This procedure involves removing the lamina of a vertebrae to decompress the spinal cord. The lamina is the bony arch on the back of each of your vertebrae.

According to medical experts, laminectomy has:

  • a success rate of about 90%
  • patient satisfaction rates above 75%
  • reoperation rates of about 18% within 5 years

Diskectomy

A diskectomy is a common treatment to remove portions of a herniated disk that are pressing on nerves, causing pain. It involves removing all or part of one of your disks to alleviate neurological symptoms, such as pain and numbness. Diskectomy is often performed together with a laminectomy.

The success rate of lower back diskectomies ranges from about 70% to 90%.

Vertebroplasty and kyphoplasty

Vertebroplasty and kyphoplasty are two minimally invasive procedures that involve injecting a glue-like cement into a vertebra to strengthen the bone. Both procedures are used to repair compression fractures caused by osteoporosis.

In a 2020 review, researchers found that people who underwent vertebroplasty or kyphoplasty for osteoporotic compression fractures were 22% less likely to die within 10 years than people only treated with conservative methods.

Nucleoplasty

A nucleoplasty is a minimally invasive procedure used to treat lower back pain caused by a mildly herniated disk. During this procedure, a surgeon guides a needle into the disk using imaging. A special wand is inserted into the needle to create heat and dissolve disk tissue. This procedure also numbs the nerves in the disks.

A 2018 study reported a short-term success rate of 67.1% when used to treat lower back herniated disks. Additional surgery was performed in 26% of people, usually within the first year.

Foraminotomy

A foraminotomy involves enlarging the holes in the vertebra where nerve roots pass through. It’s used to treat nerve root compression.

The gold standard foraminotomy technique is called the Wiltse approach. It has a success rate of roughly 80%.

Surgery for treating spinal stenosis is the most performed type of back surgery in adults. A laminectomy is usually the preferred procedure used to treat spinal stenosis.

Spinal fusion may be equally common, or more common, in people over the age of 80.

In a 2019 review, researchers analyzed the most common spinal procedure performed on adults ages 80–100 in the United States by looking at three surgical databases.

They found that spinal fusion was the most common procedure in two of the databases, making up 48.9% and 46.2% of spinal surgeries. Laminectomy and a similar surgery called laminotomy were the most common procedures in the third database, making up 51.8% of procedures.

The recovery time for lower back surgery depends on the type surgery as well other factors such as:

  • the complexity and severity of your symptoms
  • your overall health
  • your level of physical activity and fitness
  • your age

It generally takes 4–6 weeks to return to work after surgery to treat lower spinal cord compression.

For spinal fusion, you may need to take 4–6 weeks off work if you’re younger and not working a strenuous job. Older adults, or people whose jobs frequently require bending, lifting, or turning, may need to take off 4–6 months.

You may be able to return to your job 1–2 weeks after disc replacement if your job doesn’t involve heavy lifting. You may need to wait 6–12 weeks if your job involves strenuous labor.

Complications of spinal surgery

Spinal surgery can help treat many conditions, but it can also cause complications. Approximately 20%–40% of procedures aren’t successful, and complication rates are reported in about 7%–20% of them.

Potential complications of spinal surgery include:

  • bleeding or bruising
  • blood clots
  • nerve damage
  • infections
  • leakage of cerebrospinal fluid
  • reaction to anesthetic

If you have back pain, doctors typically recommend conservative treatment options before considering surgery. Some injuries, such as a severe spinal fracture, may need immediate surgery.

Conservative treatments that may help ease back pain include:

There are many types of back surgeries that are used to treat lower back pain. The type of surgery you need depends on the underlying cause of your pain and other symptoms. Procedures used to treat compression of your spinal cord such as laminectomy and spinal fusion are among the most common back surgeries.

Doctors usually recommend trying conservative treatment options before surgery, but serious injuries may require immediate surgical treatment if they have a high risk of complications.