Patients suffering from severe low back pain may fail to get relief from conservative, non-surgical treatments. When conservative treatments fail to relieve the pain, doctors may recommend spinal surgery as a final therapeutic option. Orthopedic surgeons and neurosurgeons are best equipped to recommend appropriate surgical alternatives available to each individual patient, depending on their particular situation.
Minimally Invasive Discectomy
A minimally invasive discectomy helps relieve the patient’s pain by using small, precision instruments to remove a disc bulge or herniation that is pressing on a nerve root. Approximately 10–15% of patients who have a discectomy experience recurrent bulges or herniations some time in the future.
Lumbar Laminectomy Procedure
Lumbar laminectomy is another surgical procedure to relieve pressure on spinal nerves. This surgery enlarges the spinal canal to provide additional room for spinal nerves. The surgeon accomplishes this by removing a section of bone covering the spinal canal, as well as any existing bone spurs in the problem area. Approximately 70–80% of patients experience significant improvement after undergoing this procedure.
Lumbar Spinal Fusion Surgery
Lumbar spinal fusion is a type of surgery for degenerative disc disease that attempts to relieve low back pain by stopping motion at the injured disc segment. The procedure is called a fusion because it promotes the growth of bone to fuse spinal vertebrae together.
Spinal fusion surgery typically involves the removal of damaged discs, placement of a spacer cage in the resultant empty disc spaces and the use of hardware such as rods and screws or facet bolts to stabilize the spine. Surgery may also include a partial or full laminectomy and nerve decompression.
Bone growth for the fusion process is stimulated by the use of bone fragments taken from the patient’s hip during the surgery, cadaver bone or synthetic material known as bone morphogenic protein.
Fusion surgery can be an effective option to enhance a patient’s activity level and overall quality of life. Recovery periods for standard spinal fusion surgery can be eight to 12 months or longer and is quite variable between patients. New minimally invasive techniques have decreased recovery periods and post-operative discomfort.
A potential side effect of spinal fusion surgery is a loss of motion in the fused disc segments. This tends to put additional stress on adjacent spinal discs, thus causing patients to undergo more fusion surgery later in life.
Determination of the surgery’s success is dependent on one’s viewpoint. Surgeons typically consider the procedure a success once the fusion process is complete. http://www.optinghealth.com reports that patients only consider it a success if their low back pain has been reduced or eliminated.
Artificial Disc Replacement
Artificial disc replacement is a relatively new procedure to treat pain and disability from lumbar degenerative disc disease. Replacing damaged discs with artificial devices is supposed to maintain much of the lumbar spine’s natural motion, thus reducing the chance of adjacent spinal levels breaking down from additional stress.
Since artificial disc surgery is still a new procedure, its long-term efficacy, potential risks and complications are still relatively unknown. New products and techniques are currently in development, but some studies indicate the possibility of needing to replace artificial discs within five to 10 years of initial implant.