Surgery

People who have tried conservative methods without success and continue to have ongoing disability may be candidates for surgery. The most common procedures are:

Laminectomy is performed on the lower back or neck to relieve pressure on one or more nerve roots that have been compressed either through a herniated disc, disc fragment, tumor or bone spur.

The lamina is a portion of bone in the back of the vertebra that forms an arch. Part of the lamina or the entire laminae may be removed in order to enter the spinal canal and allow sufficient room to remove a herniated disc or to open up a tight nerve hole. If there is a narrow spinal canal (spinal stenosis) that is putting pressure on the nerve sac, then the laminectomy will relieve that pressure. Sometimes, a piece of bone (bone graft) or metal rods may be used to strengthen the area of surgery.

New techniques are being developed to surgically remove herniated discs without removing any bone. These techniques are far less traumatic for the patient, but suitable for only a narrow spectrum of people.

Spinal fusion is a process by which surgery is undertaken to fuse or join together part of your spine to eliminate pain or arrest the progression of spinal deformity. Obviously, the result is the loss of spinal flexibility for the patient.

The objective is initially to remove the injured disc and any other material pressing on the spinal cord or nerve roots. The two or more vertebrae (depends on how many are abnormal) are then fused together by one of a number of techniques. One is using a bone graft usually taken from the thigh bone. Another is to join the vertebrae by screwing steel rods across them. New techniques are being developed to use a flexible material to stabilize the vertebrae but not to fuse them in a rigid fashion. Different techniques will suit different cases.

It would be wise to ask your surgeon to explain the benefits and risks associated with the surgery.