Having back surgery can be a difficult choice. Typically, people consider surgery for back pain only after all other treatments have failed to provide relief. Even then, surgery does not provide significant improvement for everyone. And while the risks of back surgery are generally low, they can be serious in some people.
Learning about back surgery ahead of time and understanding its risks and benefits can help you decide whether it's right for you.
The primary reason for most back surgeries is to get relief from back pain. And for many people, the result is less pain.
Less pain comes with many additional benefits, including:
Better physical fitness
Less need for pain medicines with fewer drug side effects
Ability to go back to work
Increased productivity at work
But not everyone experiences a reduction in back pain after surgery. Studies show it's difficult for surgeons to accurately predict who will benefit and who won't. For this reason, and because most back pain improves with time, experts recommend trying non-surgical treatments like physical therapy before considering back surgery.
Risks of Back Surgery
The overwhelming majority of people who undergo back surgery have no complications during or after surgery.
All surgeries, though, carry some degree of risk. The general risks of any back surgery can include:
Reaction to anesthesia or other drugs
Blood clots, for instance in the legs or lungs
Recurrent disc herniation
Nerve damage, which can result in weakness, paralysis, pain, sexual dysfunction, or loss of bowel or bladder control
Some risks might be higher for certain people. And the level of risk may also vary depending on the type of surgery. Part of the surgeon's job is to help you identify your risk from back surgery. Talking with your doctor before a back surgery is the best way to understand your personal risk.
Types of Back Surgery: Risks and Benefits
Each type of back surgery comes with its own risks and benefits.
Spinal Fusion. Spinal fusion is the most common surgery for back pain. In a spinal fusion, a surgeon joins spinal bones, called vertebrae, together. This restricts motion between the bones of the spine. Fusion also limits the stretching of nerves.
Reduced spinal motion does not significantly limit activity for most people. One risk unique to spinal fusion surgery is incomplete fusion of the vertebrae. That can require additional surgery. While incomplete fusion is uncommon, smoking does increase the risk.
Laminectomy. In a laminectomy, a surgeon removes parts of the bone, bone spurs, or ligaments in the back. This relieves pressure on spinal nerves that may be causing pain or weakness.
Laminectomy can cause the spine to be less stable. If the spinal bones become unstable, a spinal fusion is usually performed. Spinal fusion may also be performed at the same time as laminectomy.