When to Consider Spine Surgery for Chronic Back Pain
May 7, 2024 - Katie McCallumEvery day, millions of people experience back pain. It's usually the result of a muscle strain or sprain, but the spine itself can also be a source of various problems. When this is the case, bending, twisting, standing and walking can become unbearable. The pain can range from a dull, persistent ache to shooting, burning or stabbing sensations that radiate down the spine and even into the legs.
No wonder the CDC reports spine issues to be one of the leading causes of disability.
But when are conservative treatments enough to help manage back pain? And when is it time to consider back surgery?
"Our goal is to gain a comprehensive understanding of your situation and explore the best nonoperative or operative treatment options available to you," says Dr. Hari Mitra, an orthopedic spine surgeon at Houston Methodist. "The decision to go ahead with surgery, in particular, should not be taken lightly. But it's a viable option when pain significantly affects the quality of life, conservative treatments have not provided relief or there's nerve damage or progressive neurological decline."
Here's everything you need to know if you're looking for surgical ways to relieve chronic back pain.
When should you consider back surgery?
Most back pain resolves on its own with nonsurgical treatments — which can include everything from anti-inflammatory medications, heat or ice, over-the-counter pain patches, therapeutic massage, physical therapy and corticosteroid injections.
But if these options haven't worked, and you're experiencing pain, weakness and difficulty performing basic activities like standing or walking, it's time to see a spine specialist.
"Spine surgery is complex and involves a high level of precision," explains Dr. Mitra. "Fortunately, advancements have made it possible to use minimally invasive techniques that allow for smaller incisions, less pain and shorter recovery times."
He adds that spine surgery doesn't relieve all types of back pain, but it can be an effective solution for the following spine issues:
- Degenerative disk disease or herniated disks
- Fractures or injuries to bones in the spine
- Spinal deformities, such as scoliosis or kyphosis (abnormal curvatures of the spine)
- Spinal stenosis (narrowing of the spinal canal)
- Spondylolisthesis (when one vertebra in the lower back slips forward on top of another)
- Weak or unstable spine caused by infection or tumors
If you're experiencing back pain due to one of these structural issues, a spine specialist can advise you on your treatment options — including whether it's time to consider surgery.
The benefits of minimally invasive spine surgery
Although the decision to have surgery can be difficult, having access to specialized spine surgeons who are skilled in minimally invasive techniques and use robotic-assisted technology can help put your mind at ease.
"Instead of one long incision down the back, as is the case with traditional open surgery, a smaller incision or muscle-sparing approaches are made during minimally invasive spine surgery," explains Dr. Mitra. "This can help lessen pain and shorten recovery times."
Through these small incisions, the surgeon visualizes the spine using specialized instruments. Small surgical tools are then used to perform surgery on the affected area.
The types of spine surgery that can be performed using minimally invasive techniques include:
- Diskectomy – commonly performed to remove the herniated portion of a disk pressing on a nerve
- Laminectomy (decompression surgery) – relieves pressure caused by spinal stenosis by removing bone to enlarge the spinal canal
- Spinal fusion – permanently fuses two vertebrae together to eliminate painful movement between them. This may be done to help with degenerative disk disease, recurrent herniated disks, spinal deformities, spinal instability and other disorders.
In complex cases involving spinal decompression or spinal fusion, robot-assisted technology may also be used. The benefits of robotic spine surgery include improved surgical accuracy, less risk for complications, less blood loss and lower risk of infection.
"Robotics allow us to plan the surgery with even more precision," Dr. Mitra adds. "Before the procedure, MRI and CT imaging is used to generate computer models that help guide the placement of hardware into the spine."
Pain is not just a symptom. Pain is a signal that your body needs attention. If your back pain persists despite home remedies, physical therapy and other treatments, it may be time to see a specialist to find out if surgery is an option for you.
