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Back Surgery: Risks and Benefits

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Types of Back Surgery: Risks and Benefits continued...

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. Smoking also increases the risk of infection after back surgery.

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.

A laminectomy, however, 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.

Foraminotomy. During a foraminotomy, a surgeon cuts away bone at the sides of vertebrae to widen the space where nerve roots exit the spine. The enlarged space may relieve pressure on the nerves, thereby relieving pain.

A foraminotomy can sometimes result in reduced stability of the spine, similar to what happens in a laminectomy. A spinal fusion may be done at the same time. Doing so increases the amount of time needed for recovery but also prevents the spine from becoming unstable. If the spine becomes unstable after a foraminotomy, a spinal fusion can be done to correct the problem.

Discectomy. A bulging or "slipped" disc, the cushion that separates vertebrae, may press on a spinal nerve and cause back pain. In a discectomy, the surgeon removes all or part of the disc. A discectomy can be done through a large incision or through a smaller incision using tools from outside the body. A discectomy may be part of a larger surgery that includes laminectomy, foraminotomy, or spinal fusion.

Disc Replacement. In artificial disc replacement, a surgeon removes a damaged spinal disc and inserts an artificial disc between the vertebrae. Disc replacement permits continued motion of the spine. It is gaining popularity as an alternative to spinal fusion.

Recovery time for a disc replacement may be shorter than for a spinal fusion in many people. As with any foreign object placed inside the body, there is a small risk of the device dislodging or failing.

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