Types of Lower Back Surgery

There are many types of lower back surgery now available, but despite advanced technologies, surgery is not always successful. Therefore back surgery should only be considered when there is damage to peripheral nerves or there is the presence of progressive neurologic disease.

Additionally, it may take many months for the patient to fully heal after surgery, and he or she may, in the end, suffer permanent loss of flexibility. However, not all surgical procedures which target back pain are equally invasive. In fact some may not even require hospitalization and can be performed in a doctor’s office under local anesthesia.

If the primary cause of pain is due to neurologic disease or nerve root compression, surgery has the potential to bring relief for lower back pain.

However, if the primary cause of pain is due to chronic musculoskeletal problems, surgery does not have the power to cut out the problem.


Common Types of Lower Back Surgery

Discectomy
This is a procedure done to relieve pressure on a nerve root that’s being compressed by a bulging disc or bone spur. In order to relieve this pressure, the surgeon removes a small piece of the lamina (the bony roof of the spinal canal) from above the obstruction.

Foraminotomy
This is type of surgery is undertaken to enlarge the foramen (the bony hole) where a nerve root branches out from the spinal canal. Joints thickened with age, or bulging discs, may cause the foramen to narrow, thereby pressing on the nerve. This pressure can cause pain, numbness or weakness in the extremities. In order to relieve the pressure, the surgeon removes small pieces of bone over the nerve through a small slit, which allows her to cut away the blockage.

IntraDiscal Electrothermal Therapy (IDET)
IDET is used to treat pain caused by a cracked or bulging spinal disc. This therapy involves inserting a special needle into the disc via a catheter. Once inserted, the needle is heated to a high temperature for approximately twenty minutes, effectively thickening and sealing the disc wall. This procedure reduces inner disc bulge and spinal nerve irritation.

Nucleoplasty
Nucleoplasty is used to treat lower back pain resulting from mildly herniated or contained discs. During this procedure, a wand-like is instrument is guided by x-ray imaging and inserted through a needle into the disc in order to create a channel. This facilitates the removal of inner disc material. Several channels may be made, depending on the amount of material needing to be removed. After removal, the wand heats and shrinks the tissue of the disc wall in order to seal it.

Radiofrequency Lesioning
This procedure is used to interrupt of nerve conduction and the transfer of pain signals. Electrical impulses are used in order to destroy the nerves located in the affected area. A special needle is inserted into the localized nerve tissue, with the guidance of an x-ray. This area is then heated for 90 to 120 seconds, destroying the nerve tissue. This may result in cessation of pain for 6-12 months.

Spinal fusion
Spinal fusion is a procedure which is done in order to support a weak spine and/or to prevent painful movements. However, spinal fusion requires a long recovery period, and may result in a permanent loss of spinal flexibility. The procedure involves the removal of the spinal disc between two vertebrae, and the subsequent fusion of those vertebrae. Methods of fusion include either bone grafting and/or using metal devices secured by screws.

Spinal Laminectomy
This procedure is used to relieve pressure on the spinal cord and nerve roots. Also known as spinal decompression, this type of surgery involves the removal of the lamina to increase the size of the spinal canal.

Other Types of Lower Back Surgery

Rhizotomy
A rhizotomy is performed to block all sensation and nerve transmission from the painful area. This involves severing the affected nerve root close to where it enters the spinal cord.

Cordotomy
A cordotomy is also used to block pain referral, by cutting bundles of nerve fibers which attach to the spinal cord.

Dorsal Root Entry Zone Operation (DREZ)
By surgically destroying the spinal neurons which transmit pain, DREZ is another procedure used to eliminate the sensation of pain.

The various types of lower back surgery should be thoroughly researched before committing to a course of treatment. Make sure to get a second opinion and don't hesitate to explore more conservative treatments first.

Return to Top of Types of Lower Back Surgery

Lower Back Pain Answers Home Page