Decision Assist

Back surgery

Introduction

The purpose of this tool is to help you decide whether or not to have back surgery. When making a decision like this, you must balance:

This tool is not a substitute for professional medical care and advice. Work with your doctor to help you make this decision. A second opinion from another doctor may be valuable. There is usually no exact “right” or “wrong” answer.

Your doctor may make certain recommendations to you. However, the final decision about whether to have this surgery rests with you.

What is the surgery?

Back surgery can correct problems with the spinal bones (vertebrae), disks, or nerves of the lower back (lumbar spine).

Lumbar vertebrae

Symptoms of lumbar spine problems include:

Lumbar spinal surgery is done while the patient is under general anesthesia (unconscious and pain-free). An incision is made over the troubled area. The bone that curves around and covers the spinal cord (lamina) is removed (laminectomy), and the tissue that is causing pressure on the nerve or spinal cord is removed.

Lumbar spinal surgery - series
Click the icon to see an illustrated series detailing lumbar spinal surgery.

The hole through which the nerve passes may be enlarged to prevent further pressure on the nerve. Sometimes, spinal fusion is necessary to stabilize the area. This tool will focus on open back surgery (diskectomy) and laminectomy.

Key points

How much time this decision tool will take

What this tool will provide


Review Date: 12/31/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Previously reviewed by Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network (10/20/2008).

References:
  • Mannion AF, Elfering A. Predictors of surgical outcome and their assessment. Eur Spine J. January 2006; 15 Suppl 1:S93-108.
  • Atlas SJ, Keller RB, Wu YA, Deyo RA, Singer DE. Long-term outcomes of surgical and nonsurgical management of lumbar spinal stenosis: 8 to 10 year results from the Maine lumbar spine study. Spine. April 15, 2005;30(8):936-43.
  • McLain RF. Functional outcomes after surgery for spinal fractures: return to work and activity. Spine. February 15, 2004;29(4):470-7.
  • Katz JN, Stucki G, Lipson SJ, Fossel AH, Grobler LJ, Weinstein JN. Predictors of surgical outcome in degenerative lumbar spinal stenosis. Spine. November 1, 1999;24(21):2229-33.
  • Koes BW, van Tulder MW, Ostelo R, et al. Clinical guidelines for the management of low back pain in primary care. Spine. 2001;26(22):2504-2514.
  • Spangfort EV. Acta Orthop Scand Suppl. 1972:142:1.
  • Awad JN, Moskovich R. Clin Orthop Relat Res. 2006 Feb;443:183-97.
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