Back Surgery and Back Pain

For the vast majority (probably 90% or more) of people with back pain, this will resolve naturally within a few weeks, or will respond to treatments such as anti-inflammatories, pain-killers, heat or cold treatment, exercise or physiotherapy. For a small minority, the pain does not improve after a number of months and becomes chronic (long term). For these cases, surgery may be the last resort.

Who Needs Back Surgery?

Back surgery is a serious undertaking, and is reserved for people who really need it. Back surgery may be required when the spine has become unstable through osteoporosis or fracture, or if the vertebrae (the bones in the spine) or the discs between the vertebrae are pressing on the nerves or the spinal cord, causing pain, tingling and numbness, and the condition is getting worse, possibly affecting the bowel or bladder.

Conditions needing surgery can include:

• scoliosis (curving of the spine – see ‘What is Scoliosis?’)
• kyphosis (irregular growth of the spine, causing a hump – see ‘Scheurmann's Kyphosis’)
• spondylolisthesis (a stress fracture of a vertebra, caused by overuse
• spinal stenosis (narrowing of the gap that the spinal cord passes through – see ‘Spinal Stenosis Explained’ – can be caused by rheumatoid arthritis or osteoarthritis)
• herniated disc (damage to one of the soft discs that separate the vertebrae – see ‘Causes of Back Pain: Herniated Intervertebral Disc’)
• fractured vertebrae
• osteoporosis
• spinal infection
• intractable (untreatable) back pain
• cancer

What Does Back Surgery Involve?

Back surgery may be minimally invasive (keyhole) or traditional (open). Minimally invasive surgery is carried out through two or more small incisions using specialist tools. Back surgery may be carried out from the front (abdomen) or the back, depending on the procedure needed.

How Long Does It Take To Recover From Back Surgery?

This will depend on whether the surgery is minimally invasive or traditional. Recovery from minimally invasive surgery is much quicker than traditional surgery as it doesn’t involve a large open wound or incisions through muscles.

Time to recovery also depends on the reason for the operation, the patient’s age and the patient’s general health and fitness. Recovery from back surgery will probably take between 4 and 12 weeks, depending on the type of surgery carried out, with total recovery for most patients within six months to a year. Many patients are able to move about after about 24 hours.

The surgeon or nurse should explain whether to keep active or rest during recovery – it is generally a good idea to keep moving, with gentle exercise such as walking, eat healthily (and avoid gaining weight, as this will put extra strain on the back) and get as much sleep as possible, as this will aid healing.

What Are the Risks of Back Surgery?

There are some risks associated with back surgery, but these are usually very small. Some of these are the same risks as with any other surgery, including failure of the operation, pain, bleeding, blood clots, breathing problems, infection, problems with healing, development of scar tissue and anaesthetic complications. The risks specific to back surgery include damage to the spinal cord resulting in numbness or paralysis, bowel or bladder problems, or instability of the spine.