If you have reached the decision to undergo surgical treatment for low back pain, it is likely because other, more conservative treatments have failed to relieve your symptoms. The particular surgery used to treat low back pain depends heavily on the type of back pain the patient experiences. The surgical options listed below are used to treat nonspecific back pain, that is, back pain without a clearly identifiable condition. The two major treatment options for nonspecific low back pain are lumbar spinal fusion and lumbar disc replacement.
Lumbar Spinal Fusion
As the name implies, lumbar spinal fusion is the fusion of individual vertebral bones together. Lumbar spinal fusion using bone grafts placed between vertebral bones to cement them together. While the bone graft adheres to the vertebral bones and they solidify/heal, the vertebral bones may be held together with various rods, screws, and other structures (collectively called hardware) to give the spine the support it needs and to restrict movement. Some patients may also be required to wear a back brace while the bone graft heals.
Bone grafts may be collected from the patient him or herself, from a cadaver, or a number of synthetic materials can be used. Synthetic bone graft materials includedemineralized bone matrices, bone morphogenetic proteins, and synthetic calcium/phosphate ceramics.
Incomplete vertebral bone fusion is a possible risk and is more common in smokers and in patients with certain medical conditions.
Lumbar Disc Replacement
A vertebral disc can be thought of as a joint, somewhat like a knee or hip. It provides a cushion between two bones and prevents them from directly contacting one another. Much like other joints in the body, vertebral discs break down over time and some require replacement. Lumbar disc replacement is the removal of one or more vertebral discs and replacement with a synthetic disc. The prosthetic disc provides cushioning and space between vertebral bones while preserving flexibility of the spine, something that is lost in lumbar spinal fusion surgery.
There are several types of synthetic/prosthetic vertebral discs, and the technology is constantly improving. Your orthopedic spine surgeon will be able to present your options and discuss the pros and cons of each type.
Which Surgical Treatment of Low Back Pain Is Right for You?
Surgical treatment for nonspecific low back pain is a personal decision. Your orthopedic spine surgeon can provide you with options and can suggest the preferred course of action. Nevertheless, when it comes to choice of materials and surgical approach, every patient has an opportunity to voice his or her preferences and make an informed choice prior to engaging in low back pain surgery.