Understanding the Different Types of Spinal Surgery

Spine surgeries are procedures performed on your spinal column and surrounding tissue. Spinal surgeons use specialized instruments and materials to manipulate and modify your bones, intervertebral disks, and other tissues.

Most spinal surgeries are performed to treat the symptoms of painful conditions resulting from injury, disease, or chronic wear and tear. The type of spine surgery that’s best for you will depend on several factors, including the cause and location of your pain.

Spine surgeries can involve many surgical techniques, including:

• removing excess or problematic pieces of bone
• adding adhesive material or hardware to strengthen and support your bones
• fusing bones together
• reducing or removing the cushiony disks between your vertebrae
• implanting artificial disks

Let’s take a look at the various spinal surgeries in more detail.

1. Vertebroplasty

A surgeon injects medical cement into your vertebrae using a specialized needle. The cement helps fortify your bones. This procedure is often used to treat fractured vertebrae resulting from osteoporosis.

2. Kyphoplasty

A kyphoplasty is very similar to a vertebroplasty but involves an extra step. A surgeon inflates a balloon within the bone to create a larger cavity where they can inject the cement.

3. Laminectomy

During a laminectomy, a surgeon removes the vertebral bone that serves as the roof of the spinal canal, called the lamina. They do this to relieve pressure in your spine that’s causing pain or other symptoms. This procedure is often used to treat spinal stenosis.

4. Diskectomy

In this procedure, a surgeon removes damaged tissue from one of your disks. The disks in your spine act as cushions between your vertebrae. If a disk is damaged, it can lose its proper shape and press against nerve roots in your back, causing pain and other symptoms.

5. Spinal fusion

During spinal fusion surgery, a surgeon uses a bone graft or metal hardware to permanently fuse two vertebrae.

This surgery often isn’t a good fit for younger people because it can affect your range of motion. But it can bring relief for people with conditions that make it painful to move in certain directions.

6. Foraminotomy

Many nerve roots branch off your spinal cord and travel to other parts of your body. These nerves can become pinched when something presses against them. A foraminotomy widens the space that your affected nerve passes through, helping to relieve pressure.

7. Nucleoplasty

This procedure is similar to a diskectomy, but it involves removing tissue from inside one of your spinal disks. Surgeons do this with a special laser that heats the tissue until it dissolves.

Spinal surgeries can be separated into two broad categories: open surgery and minimally invasive spine surgery (MISS).

During a traditional open surgery, the surgeon makes an incision along your back and moves muscles and other tissues aside to access your spine.

During MISS, a surgeon makes smaller incisions on either side of your spin. They then use specialized tools and imaging techniques to perform the surgery through these incisions.

MISS causes less damage to your muscles, which can reduce recovery times and cause less pain.

Spine surgeries are usually reserved for people who have not responded well to less invasive treatment options such as:

• physical therapy
• over-the-counter medications (Advil, Aleve)
• prescription medications (muscle relaxers, corticosteroids, anti-inflammatories)
• back injections

Your doctor will also consider other factors, such as your age, overall health, and lifestyle, when deciding whether surgery is a good fit for your needs.

Depending on what type of surgery you’re having (and whether it’s an open surgery or a MISS), you might go home the same day or need to stay in the hospital for up to 5 days.

You’ll likely need to participate in physical therapy as part of your recovery. It could take weeks to months before you can fully return to your usual activities.

Pain after spine surgery is common and is usually treated with medications such as:

• nonsteroidal anti-inflammatory drugs
• corticosteroids
• ketamine

Your doctor may also prescribe opioids to help manage your pain in the days after your surgery. When taken as directed, opioids are safe to use and won’t lead to dependence or addiction. But you should talk with your doctor about any concerns, especially if you’ve had a substance use disorder in the past.

All surgeries come with risks such as infection and bleeding. Your doctor can provide more information about your particular risk factors and how to minimize those risks.

Possible spine surgery complications include:

• nerve damage (pain, weakness, paralysis)
• recurrence of symptoms
• dural tear
• spinal instability
• persistent pain at the bone graft site
• decreased range of motion

Before undergoing a spine surgery, you’ll want to make sure you don’t have any lingering questions. Here are some questions you might consider asking your surgeon during your consultation:

• What should I do to prepare for the surgery?
• How much experience do you have with this type of surgery?
• Can you share your outcomes data (results history) for this type of procedure?
• What kind of results can I expect?
• Will this surgery limit my range of motion or have other lasting effects?
• How long will recovery take, and will I need physical therapy?
• How can I manage pain after the surgery, and what methods besides medication might be useful?
• What are the risks associated with this procedure, and can they be reduced?

There are many types of spine surgery, just as there are many reasons you might need a spine surgery.

These surgeries are usually recommended only if you’ve already exhausted the less invasive treatment options.