Depending on the diagnosis, surgery may either be the first
treatment of choice - although this is rare - or it is reserved for chronic
back pain for which other treatments have failed. If you are in constant pain
or if pain reoccurs frequently and interferes with your ability to sleep, to
function at your job, or to perform daily activities, you may be a candidate
In general, there are two groups of people who may require
surgery to treat their spinal problems. People in the first group have chronic
low back pain and sciatica, and they are often diagnosed with a herniated disc,
spinal stenosis, spondylolisthesis, or vertebral fractures with nerve
involvement. People in the second group are those with only predominant low
back pain (without leg pain). These are people with discogenic low back pain
(degenerative disc disease), in which discs wear with age. Usually, the outcome
of spine surgery is much more predictable in people with sciatica than in those
with predominant low back pain.
Some of the diagnoses that may need surgery include:
Herniated discs: a potentially
painful problem in which the hard outer coating of the discs, which are the
circular pieces of connective tissue that cushion the bones of the spine, are
damaged, allowing the discs’ jelly-like center to leak, irritating nearby
nerves. This causes severe sciatica and nerve pain down the leg. A herniated
disc is sometimes called a ruptured disc.
Spinal stenosis: the narrowing of the
spinal canal, through which the spinal cord and spinal nerves run.
It is often caused by the overgrowth of bone caused by
osteoarthritis of the spine. Compression of the nerves caused by spinal
stenosis can lead not only to pain, but also to numbness in the legs and the
loss of bladder and/or bowel control. Patients may have difficulty walking any
distances and may also have severe pain in their legs along with numbness and
Spondylolisthesis: a condition in
which a vertebra of the lumbar spine slips out of place. As the spine tries to
stabilize itself, the joints between the slipped vertebra and adjacent
vertebrae can become enlarged, pinching nerves as they exit the spinal column.
Spondylolisthesis may cause not only low back pain but severe sciatica leg
Vertebral fractures: fractures caused
by trauma to the vertebrae of the spine or by crumbling of the vertebrae
resulting from osteoporosis. This causes mostly mechanical back pain, but it
may also put pressure on the nerves, creating leg pain.
Discogenic Low Back Pain (Degenerative Disc
Disease): Most people’s discs degenerate over a lifetime, but in
some, this aging process can become chronically painful, severely interfering
with their quality of life.
Following are some of the most commonly performed back