Surgery for Back Pain in Adults
If back pain continues after six months of nonsurgical treatment, NYU Langone doctors may recommend surgery. At NYU Langone, your surgical team may include orthopaedic surgeons or neurosurgeons with special training in treating back problems.
You may need surgery to treat back pain if treatments such as medication, physical therapy, or steroid injections do not provide relief, or if you have a structural problems of the spine, such as a herniated disc, degenerative disc disease, or spinal stenosis.
For example, if a vertebra slips out of place and constricts the spinal canal, causing back pain or pinching a nerve—a condition called spondylolisthesis—surgeons may perform a procedure called a spinal fusion to relieve chronic back pain. This procedure corrects spinal misalignment and removes any bone spurs, ligaments, or disc material that may be putting pressure on the spinal cord or nerve roots inside the spinal canal. It alleviates pain by creating space in the spinal canal and decompressing the nerve roots or the spinal cord.
Spinal fusion involves permanently joining the problematic vertebrae together using screws, rods, or a small piece of bone called a bone graft. These remain in your spine and act like an internal brace to keep the bones in the correct position. If a bone graft is used, it is taken from your own body, typically from the hip, or from a donor through a bone bank. It’s placed either directly alongside the spine, between the vertebrae to be fused, or inside a small metal cage that’s placed between vertebrae, which can give it extra stability.
Over time, the joined vertebrae heal, fusing into one bone mass that provides the spine the stability it needs to support the body.
What to Expect After Spinal Surgery
After surgery, you spend several hours in the recovery room. You may have to stay in the hospital for a few days after surgery before you are cleared to return home. NYU Langone pain management specialists are available 24 hours a day to make sure you’re comfortable during the initial stages of recovery.
A physiatrist—a doctor specializing in physical rehabilitation medicine—may visit you after surgery to help you get used to moving with the newly fused bones. A physical therapist may also visit you to help you stand and walk, and demonstrate simple exercises for rebuilding strength in the muscles in and around your back. At first, you may need a walker or a cane to get around, but after a few weeks you should be able to walk on your own.
Some people need to wear a brace after surgery for extra spinal support, especially if the procedure fused several vertebrae. If your doctor recommends a back brace, an orthotics specialist can customize it for you.
Before you go home, doctors give you pain medication to be taken by mouth in the weeks after surgery. How long medication is required and how quickly your back heals depends on your age, the amount of time you had symptoms, and the type of condition you had, such as degenerative disc disease, before surgery.
For most people, a full recovery from spinal fusion takes 6 to 12 months, but in complicated cases may take longer. Doctors schedule a follow-up appointment after surgery, then every six to eight weeks until your bones have healed. During these appointments, doctors may use imaging tests such as X-rays or CT scans to monitor your healing.