Spine and Neck

Conservative Approach to Back & Neck Pain

Back surgery can help relieve some causes of back pain, but surgery is often not a first or second line therapy and may not be needed at all.

Back pain is very common and typically responds very well to nonsurgical treatments such as anti-inflammatory medications, heat and physical therapy. While a majority of back pain may resolve on its own within three months, it is important to talk to an orthopedic surgeon if you have unexplained back pain, suspect a spine fracture or suffer from severe or continuous back pain.

Our team specializes in:

  • Complex spine surgery
  • Minimally invasive spine surgery
  • Spinal tumors
  • Scoliosis
  • Spinal fractures

When the most conservative therapies do not bring relief, surgery may be part of your treatment plan.

      Do You Need Back Surgery?

      After conservative treatments have been discussed, prescribed and tried, and pain continues to be persistent and debilitating, spinal surgery should be discussed with your back specialist or orthopaedic surgeon. If, after your other treatments, you continue having pain or numbness that goes down your extremities, surgery might be the best option. These symptoms often are caused by compressed nerves in your spine. This may happen for a variety of reasons, including:

      • Overgrowth of bone: Osteoarthritis can result in bone spurs on your spine. This excess bone most commonly affects the hinge joints on the back part of the spinal column and can narrow the amount of space available for nerves to pass through openings in your spine.
      • Disk problems: Bulging or ruptured (herniated) disks — the rubbery cushions separating the bones of your spine —sometimes press too tightly against a spinal nerve and affect its function.

      Different Types of Back Surgery

      Just as there are multiple types of back injuries and reasons for back pain, there are different types of back surgery. The most common include:

      Laminectomy: In this procedure, a surgeon removes parts of the bone, bone spurs, or ligaments overlying the spinal canal. It is also performed to relieve nerve pressure caused by spinal stenosis. This enlarges the spinal canal and relieves pressure on spinal nerves and often reduces pain or weakness. However, it can make your spine less stable. If that happens, you may need a spinal fusion. These two treatments are often done at the same time.

      Foraminotomy: A surgeon cuts away bone at the sides of your vertebrae to widen the space where nerves exit your spine. The extra room may relieve pressure on the nerves and ease your pain. Like a laminectomy, this procedure can also make your spine less stable. If this is the case, your surgeon may do a spinal fusion at the same time.

      Discectomy: Sometimes a disk slips out of place, presses on a spinal nerve, and causes back pain. In this procedure, a surgeon removes all or some of the disk, the herniated portion. This is to relieve irritation and inflammation of a nerve. Sometimes it’s part of a larger surgery that includes laminectomy, foraminotomy, or spinal fusion.

      Fusion: This is the most common surgery for back pain. A spinal fusion permanently joins two or more bones (vertebrae) in your spine. It can relieve pain by adding stability to a spinal fracture. It is occasionally used to eliminate painful motion between vertebrae that can result from a degenerated or injured disk. Fusion limits the motion between the vertebrae and reduces how far your nerves can stretch. But it likely won’t limit your activity.

      Artificial disks or disk replacement: A surgeon removes the damaged spinal disk and implants artificial disks as an alternative to spinal fusion. This is often used for pain between two vertebrae due to a degenerated or injured disk.

      Interlaminar implant: A surgeon implants a U-shaped device between two vertebrae in your lower back. This helps keep the space between them open and eases pressure on your spinal nerves. It can be done at the same time as a laminectomy. This is less restricting than a spinal fusion.

      If your orthopedic provider has recommended surgery, it is key to know that while back surgery can provide a reduction in pain, other benefits may include:

      • Improved and elevated mood
      • Better mobility
      • Improved physical fitness
      • Reduction or removal of pain medication
      • Ability to work standard jobs and standard hours


      Service Providers

      Benjamin Blair, MD
      Orthopedics, Spine and Neck