When we think of back surgery, we tend to believe that all the procedures are more or less the same. It’s back surgery, right? But, in fact, there are a large number of procedures. Each has it’s own indications and outcomes. Among the most common back surgeries, per the Mayoclinic.org, are:
• Diskectomy. This involves removal of the herniated portion of a disk to relieve irritation and inflammation of a nerve. Diskectomy typically involves full or partial removal of the back portion of a vertebra (lamina) to access the ruptured disk.
• Laminectomy. This procedure involves the removal of the bone overlying the spinal canal. It enlarges the spinal canal and is performed to relieve nerve pressure caused by spinal stenosis.
• Fusion. Spinal fusion permanently connects two or more bones in your spine. It can relieve pain by adding stability to a spinal fracture. It is occasionally used to eliminate painful motion between vertebrae that can result from a degenerated or injured disk.
• Artificial disks. Implanted artificial disks are a treatment alternative to spinal fusion for painful movement between two vertebrae due to a degenerated or injured disk. But these relatively new devices aren’t an option for most people.
Given how reluctant most insurers are to pay for back surgery, it falls to the patient and the surgeon to make sure the surgeon performs the best procedure. From my very limited review of medical records, it seems as if the most common procedure is the fusion. This seems to be done most often at L4-L5-S1. It could be that surgeons feel that a fusion is the best way to address the underlying back problems. If a lesser procedure, such as a diskectomy fails, the patient runs the risk of needing more surgery. Each procedure brings with it such risks as infection. If you are a surgical candidate, make sure you discuss with your doctor all the possible surgeries to decide which is best for you.
