No matter what shape you’re in, back pain is increasingly likely the older you get. In fact, around 85% of people experience back pain during their lifetime, and low back pain is the top reason for disability worldwide. Although most back or neck pain will go away with time, chronic back pain may resist multiple forms of nonsurgical treatment. In these situations, you may need surgery for back pain. Minimally invasive procedures are available to treat many causes of back pain, according to a University of Maryland Medical System Live Greater podcast. If you’re wondering whether this type of surgery could be what you need, you might be surprised.
What Is Minimally Invasive Back Surgery?
Minimally invasive surgery is a modern technique that uses only small incisions during the procedure. While not every surgical procedure can be performed this way, it is common for many types of back surgery.
Using minimally invasive techniques helps to ensure only minor disruption in the soft tissue surrounding your spine. Many procedures use a tubular retractor, which allows a surgeon to cut the skin and then gently push through the muscle tissue without cutting it. This helps ensure a less painful recovery because the tissues return to their original position after surgery without wounding.
Because minimally invasive surgery uses smaller incisions than traditional open surgery, it is technically more challenging for a surgeon to perform. Spine surgeons should have special training to perform minimally invasive surgery, and surgeons who use precision robotic technology to help perform the surgery need additional training.
Benefits of Minimally Invasive Spine Surgery
There are a wide range of benefits of minimally invasive spine surgery, including:
- Faster recovery time
- Less pain
- Lower risk of bleeding during and after surgery
- Lower risk of infection
- Shorter hospital stays or outpatient surgery
- Less noticeable scarring due to smaller incisions
Many minimally invasive back surgeries use only local anesthesia, which decreases your risk of adverse reactions to general anesthesia. Patients are less likely to need a long course of pain medication after surgery. Also, with minimally invasive techniques, many patients return to work or activities they love in just two to three weeks, with few limitations on their movements.
Why You Could Need Surgery for Back Pain
The parts of the back that commonly need surgery for chronic pain are the lumbar spine (lower back) and the cervical spine (neck). Several common conditions lead to severe pain in the neck and lower back, including:
- Herniated discs, also called slipped or ruptured discs, happen when a cushioning disc between two vertebrae moves out of place.
- Spinal stenosis. This happens when part of your spinal canal narrows and puts pressure on your spinal cord and nerve roots, leading to pain.
- Spondylosis, or osteoarthritis of the spine. Also called degenerative disc disease, this condition is caused by normal wear on your vertebrae as you age.
- Spondylolisthesis. This condition leads to one vertebra slipping out of place, pressing on other bones or nerves.
Fractures, infections, tumors and deformities of the bone, such as scoliosis, can also cause back pain.
Common Minimally Invasive Spine Surgeries
More types of back surgery than ever can be done using minimally invasive techniques, but the most common procedures include:
- Discectomy. This treatment for a herniated disc removes part or all of the damaged disc.
- Spinal decompression. This treatment for spinal stenosis removes tissue in the spinal column to reduce pressure on nerves. Types of decompression surgery include foraminotomy and laminectomy.
- Transforaminal lumbar interbody fusion (TLIF): This surgery uses bone grafts and metal pieces to fuse vertebrae. TLIF helps treat spondylosis, spondylolisthesis and recurring herniated discs.
You May Not Need Surgery
Many people with chronic back or neck pain do not need surgery. Before you consider surgery, you should have tried conservative treatment options, such as:
- Lifestyle modifications, such as losing weight and quitting smoking
- Medication management
- Physical therapy
However, some back pain will not respond to conservative treatment. Other people may find their pain aggravated by physical therapy or strengthening exercises. If you’ve tried everything to avoid surgery and your pain has not improved after one year, back surgery may be a good option.
Are You a Candidate for Minimally Invasive Back Surgery?
Many people who may not have been good candidates for traditional open surgery for back pain can safely have minimally invasive surgery, including:
- Older people who can benefit from reduced blood loss and faster recovery time
- Patients with spinal deformities, tumors or other problems that have only been treated with open surgeries in the past
- People who are overweight because they will need less tissue cut using smaller incisions
Some patients may need to manage comorbidities before surgery. Your doctor may want you to lose some weight or make sure your blood sugar is under control. Some patients also may need to start physical therapy before surgery to get stronger for the best outcome.
Only You Can Decide About Surgery for Back Pain
In most cases, surgery should be a last resort for non-emergency causes of back pain. If you’re considering surgery, it’s important to feel comfortable with your orthopedic or neurosurgical team. You should always feel like you can ask for a second opinion about whether you need surgery or if the surgery recommended is your best option.
The UM Spine Network takes a conservative approach to surgery and welcomes second opinions. When they recommend surgery to patients, it is solely because they see a huge potential for improvement of symptoms. If your back pain is debilitating, there is light at the end of the tunnel.
Listen to a Podcast
Do you have back pain? Minimally invasive surgery might be your answer. In this podcast, Dr. Khalid Kurtom and nurse practitioner Wendy Towers from UM Shore Regional Medical Group – Neurosurgery, a member of the UM Spine Network, talk about this procedure, who can benefit from it, some of the cutting-edge advances, and much more. Listen below or download it here.
Medically reviewed by Khalid Kurtom, MD and Wendy Towers, CRNP.
