If you’ve been told you need spine surgery, you might be confused by the many different types of back surgery. The term “spinal surgery” is very broad and doesn’t tell you much about the procedure being done. Read on to discover some of the different types of back surgery and what your doctor will be doing during each.
Minimally Invasive Spine Surgery
Minimally invasive back surgery doesn’t refer to one specific procedure, but rather a technique that can be applied to most of the types of back surgery procedures we’ll talk about here. As you might guess from the name, minimally invasive back surgery involves working through very small incisions, rather than performing full open surgery.
Doctors can perform a number of procedures with minimally invasive techniques. These can include lumbar decompression, fusion, facetectomy, foraminotomy, and more. Some doctors can even use robots to assist them with these procedures, making them even more precise and keeping your recovery process as easy as possible.
The Most Common Types of Back Surgery
Spinal fusion is a tremendously common type of back surgery to treat back and neck pain. In particular, this treatment works when you have a vertebra (the bones in your spine) that has become so degenerated that it isn’t supporting your neck or back anymore. Spine surgeons will remove this vertebra, leaving a gap between the two that surround it.
In order to keep those two vertebrae from collapsing into each other, doctors will put a piece of bone where the previous vertebra was. They’ll affix this in place with screws and metal plates, and as the body naturally heals, it will grow new bone around the graft. Within a few months, the two surrounding vertebrae and the graft will be joined into one solid piece of healthy bone.
In between each of your vertebrae, you have a fibrous disc that helps to cushion and pad your vertebrae. In some cases, while your vertebrae may be healthy enough, your discs may have broken down and stopped properly padding the bones of your spine. When this happens, you may need an artificial disc replacement, a newer type of back surgery that your surgeon might recommend instead of spinal fusion.
During this procedure, your spine surgeon will remove the degenerated disc through a small incision in your neck or back. The surgeon will then insert a new custom-made disc and attach it to the vertebrae that surround it. These artificial discs are usually made of two metal end plates with a plastic spacer in between. Artificial disc replacement is most commonly performed in the cervical region for neck and arm pain. You can read more about this in our blog post, Disc Replacement Surgery for Neck Pain Offers Many Advantages.
In some cases, your disc may be damaged, but not badly enough to warrant removing the whole thing. You may have suffered a herniated disc, or your disc might be intruding into your spinal column, compressing your nerves. Your surgeon may need to perform a discectomy or microdiscectomy to relieve your pain.
During a microdiscectomy, your surgeon will remove a small portion of one of your facets, the connecting tissue between the vertebrae, to both relieve pressure on your nerve and provide access to the damaged disc. From there, your surgeon will remove the pieces of the disc that have herniated or protruded into the spinal column. Your spine surgeon also may need to cut a small hole in your lamina, the protective covering around your spinal canal that separates your nerves from your vertebrae.
Your vertebrae have several protrusions on them called facets; in particular, each vertebra has four facets. Two facets face upward and two face downward, and each interlocks with the vertebrae around them. The facet joints are the connections between the bones of the spine. The nerve roots pass through these joints to go from the spinal cord to the arms, legs and other parts of the body. These joints also allow the spine to bend and twist, and they keep the back from slipping too far forward or twisting without limits. Over time your facet joints can become misaligned and rub or pinch your spinal nerves, leading to facet joint pain. This condition often is caused by a type of arthritis called facet arthropathy.
A facetectomy removes part of these facets to relieve pressure on your spinal nerves. Your surgeon will begin by removing a small piece of your lamina to get access to your facets The surgeon will then remove the smallest possible amount of bone to relieve the pressure on your spinal nerves.
In some cases, a foraminotomy may be performed alongside a facetectomy. This procedure helps to relieve pressure on your spinal nerves, which exit your spinal cord through small holes called neuroforamina. Over time, these neuroforamina may get smaller, pinching the root of your spinal nerves.
During a foraminotomy, your spine surgeon will examine the neuroforamen to figure out what’s blocking it. This may be bone, disc material, or another tissue that has grown into the passage over time. Your surgeon will remove enough of this material to relieve pressure on the nerve that’s being pressured.
Laminectomy and Laminotomy
We’ve mentioned your lamina a few times, and in some cases, the lamina itself can be the thing compressing your nerves. Your lamina is a body covering that encases the inside of your spinal column, the hole in your vertebrae that your nerves pass through. This covering can get pressed into the nerves when a disc herniates, a vertebra slips, or other pieces of your spine wear down.
There are two types of back surgery that address this condition. A laminectomy removes a part of the lamina that is compressing the nerves in your spine. This procedure also may be performed as part of some of the other procedures we’ve discussed here. A laminotomy creates small, targeted holes in your lamina above and below a compressed nerve to help relieve pressure.
Learn About the Different Types of Back Surgery
Various types of back surgery can relieve back and neck pain and give you your life back. There are dozens of different types of back surgery, and the ones we’ve discussed here are just a few. If you are experiencing back pain, Neurosurgery One offers comprehensive care to diagnose what is causing the pain and start you on the journey back to health. We offer all levels of treatment, from initial diagnosis and physical therapy to spinal injections and interventional pain management procedures, including nerve blocks and spinal cord stimulation. If your condition requires surgery, our Denver spine surgeons offer multiple types of back surgery, including many minimally invasive spine surgery procedures.
If you’d like to learn more about the different types of back surgery, check out the rest of our site or download one of our free guides. We are a Centura Health clinic that dedicates our days to making yours better. We have eight Denver area locations. Find a location near you today and discover how we can return function, relieve pain, and restore your quality of life.