Should i have spine surgery

Unfortunately, high-quality back rehab programs involving a team of specialists can be expensive—and health insurance may not fully cover it. In contrast, surgery is generally paid for if a doctor signs off on it. The prospects for surgery improve if the pain can be traced to a specific spinal disc. However, in this case the right repair is not fusion; it is usually a procedure called discectomy.

As spinal discs stiffen and start to break down, the sides may protrude outward, pressing on nearby nerves. The walls sometimes split open herniate , allowing the softer, gelatinous material inside to squeeze outward. The telltale sign of a disc problem is sciatica—pain that radiates down the buttock, thigh, back of the leg, or calf.

For new disc pain, conservative care is the best first step. If sciatica persists or worsens despite conservative care, you might consider discectomy to relieve pain by removing the portion of the disc pressing on nearby nerves. However, studies suggest that a year of conservative therapy is about as effective as discectomy. Therefore, the decision to have discectomy depends on whether you prefer more immediate pain relief.

Spinal stenosis is a common problem in the aging spine. Stenosis means the space around the spinal cord has narrowed. Bulging discs and overgrowth of bone and ligaments can all contribute to the narrowing, which presses on the nerves and causes pain. In some cases, fusion can be part of the solution. If conservative measures such as pain relievers and physical therapy are not controlling the pain and it affects your ability to get around, surgery may be worth considering.

The most common procedure for stenosis is called laminectomy, which involves removing the bony plate lamina on the back of a vertebra. This opens up more space for the spinal nerves.

Fusion should be considered for spinal stenosis only if a vertebra has slipped forward with respect to its neighbor, a condition called spondylolisthesis.

Be especially wary of "complex" fusions that involve more than two vertebra being joined with hardware. These increase the risks of the procedure. Atlas says that in older people who have a complex fusion instead of a simple laminectomy, the risk of death rises from around two or three deaths for every 1, procedures to 10 to 20 deaths per 1, That's a significant jump.

Like any surgical procedure, spinal fusion comes with risks as well as potential benefits. Instead of rolling the dice with "last resort" surgery, make sure you know what's causing the pain and whether fusion is a reasonable option. For new back pain or a recurrence of an existing back pain condition, try these measures before surgery:. Thoughtful consultation with a specialist is the best way to answer the question: Is spinal surgery really necessary?

The answer is yes. There are several alternative therapies that should be tried before deciding to undergo an operation.

Non-surgical alternatives include:. Non-surgical therapies should be tried, in combination or by themselves. Your physician should direct your course of treatment. If the non-surgical therapies have not alleviated your symptoms after six months, and they are interfering with daily life, then it is probably time to consider surgery. In many cases, non-surgical therapies cannot fix the underlying cause of your symptoms.

There are many reasons to seek a surgical alternative to your spinal disorder. For example:. Surgery is not for everyone -- and your physician knows that. When you see a spine specialist, surgery is one option they may consider.

However, they might have ideas for curing back pain or instability without surgery -- such as physical therapy or acupuncture.

It's normal to feel pain after surgery, especially if you have just had a major procedure. In general, pain is usually the worst during the first one to three days after the surgery.

After that, it should begin to subside. You may feel some mild to moderate pain for up to six weeks after the surgery, but you should not feel severe pain.

Very severe pain -- especially after the first few days following surgery -- is not a typical part of recovery. Neither is pain along with fevers, chills, numbness, tingling sensations, or loss of bladder or bowel control. If you have these symptoms, or severe pain that will not go away, get medical attention immediately.

It's true that some back surgeries do take quite some time to heal. However, recovery time depends on many factors, such as your age, the part of your back being operated on, the specific procedure being performed, or your overall health.

For example, recovery from a discectomy or foraminotomy might take only a couple of weeks. Nerves may become compressed for a variety of reasons, including:. It can be very difficult to pinpoint the exact cause of your back pain, even if your X-rays show that you have disk problems or bone spurs. X-rays taken for other reasons often reveal bulging or herniated disks that cause no symptoms and need no treatment.

Before you agree to back surgery, consider getting a second opinion from a qualified spine specialist. Spine surgeons may hold different opinions about when to operate, what type of surgery to perform and whether — for some spine conditions — surgery is warranted at all. Back and leg pain can be a complex issue that may require a team of health professionals to diagnose and treat. There is a problem with information submitted for this request. Sign up for free, and stay up-to-date on research advancements, health tips and current health topics, like COVID, plus expert advice on managing your health.

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