Question

Surgical Procedures

What are surgical treatments for neck and low back pain?

A Answers (2)

  • ASergio Gonzalez-Arias, MD, Neurosurgery, answered on behalf of Baptist Health South Florida
    The majority of people with low back or neck pain from cervical disc disease or disorders will respond to some degree from non-surgical treatments, such as therapy. But if symptoms such as pain or numbness persist, then surgery can be a viable option.

    Cervical disc disorders are caused by an abnormality in one or more discs, or the cushions that sit between the neck bones (vertebrae). When a disc is damaged -- due to arthritis or other causes -- it can result in neck or back pain from inflammation or muscle spasm. In severe cases, pain and numbness can occur in the arms from pressure on the cervical nerve roots. A similar scenario can unfold in the lower back, with pain and numbness possibly moving down to your legs and feet.

    Surgery for cervical disc disease normally requires removing the disc that is pinching the nerve or pressing on the spinal cord. This surgery is called a discectomy. Depending on the location of the disc and other factors, a small incision may be all that's needed. A similar technique, microdiscectomy, removes the disc through a smaller incision using a microscope or other magnifying device.

    To close the space that's left when the disc is removed and restore the spine to its original height, there are generally two options: cervical fusion, which uses bond graft to fill the space, or artificial cervical disc replacement.

    Those who get an artificial disc can opt for cervical fusion later. But if you have cervical fusion first, it's not possible to later put an artificial disc in the same spot.
  • In people who have not responded to less invasive treatment, who have an identifiable structural abnormality that can be effectively corrected, or who have chronic severe pain, nerve damage, and loss of bladder and bowel control, doctors consider neck or back surgery. Common surgical procedures for neck and back pain include:

    • Microdiscectomy: In some people a herniated disc can be surgically repaired to restore the normal anatomic structure.
    • Discectomy or laminectomy: In these procedures the disc that is causing pain or the bone placing pressure on the spinal cord is removed.
    • Spinal fusion: In this procedure surgeons stabilize the vertebrae using metallic devices and bone from another part of the body, a bone bank, or artificial bone.

    Surgical innovations include:

    • Minimally invasive spinal surgery: Many spinal procedures can be performed with less injury to muscle, ligaments, and bone with equal or even better outcomes.
    • Computer navigation for spine surgery: Advancements in intraoperative imaging and navigation systems make spine surgery safer.
    • Artificial disc implantation: Artificial discs are designed to provide support for the vertebrae while permitting a range of motion.
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