Back Surgery: 7 Types, Recovery Time, Risks and Benefits for Pain

• Elimination of pain that will allow you to get back to living a pain-free life
• Increased range of motion, giving you more freedom to do the physical things you enjoy 
• Reduced intake of medications
• Reduced possibility of further procedures and additional treatments
• Minimally invasive options are available 

• Bleeding and infection
• Heart attack
• Stroke
• Blood clots
• Risk of nerve damage
• Reaction to anesthesia 
• Need for additional procedures
• Infection

What it is: 

Deuk Laser Disc Repair is a minimally invasive procedure where the surgeon uses an endoscope (a narrow tube with a light and camera attached) to reach the source of back pain without the removal of stabilizing joints, bones or ligaments. The procedure is peer reviewed and published as a safe and effective FDA approved treatment for back pain from annular tears, herniated discs, bulging discs, degenerated discs and spinal stenosis.

Using a thin endoscope to envision the damaged disc, the surgeon uses a precision laser to remove only the damaged disc tissue causing pain.(link here to animation) This damaged tissue is only 5 to 10% of the total disc tissue; therefore, the precision laser will not damage the surrounding bone and tissues, preserving the healthy disc. By leaving this healthy disc tissue in place, spinal implants like artificial discs, screws, rods, cages and fusion are not necessary and patients are up walking just minutes after the surgery. No hospital is needed for this outpatient procedure.

The laser energy obliterates the herniated disc material and debrides the annular tear, allowing pain-causing inflammation to cease. This unique technique gently spreads open tissues microscopically avoiding the damage other types of spine surgery mentioned below cause. The safest approach to your spine is used every time hence avoiding the complications of dangerous open surgeries and those required to go through your stomach to your spine. 

Deuk Laser Disc Repair can treat bulging discs, sciatica, spinal stenosis, pinched nerves, herniated discs and other conditions that cause intense, chronic pain. This procedure requires no hospital stay, no narcotic pain killers, and no opioids. After the procedure, patients can walk out of the facility with a ¼ inch incision and a bandaid.

Deuk Spine Institute has a 95% success rate in eliminating pain with zero complications in sixteen years of performing this procedure and even offers a surgical warranty for patients choosing this option.

By traveling the world and studying emerging surgical technologies and techniques, Dr. Ara Deuk medjian was able to develop his laser technology taking into account various best practices.. He’s been able to develop an innovative and unique method of using laser technology to heal the spine avoiding any fusions, drilling, implants or pain.

Recovery time: 

This precision laser procedure is uniquely recognized for its gentle, minimally invasive method. The method avoids explicitly drilling, implanting, or fusing. Leaving patients free of pain and able to walk out of the recovery room within an hour.. With just a 4-millimeter incision and no internal damage or scarring the wound will heal within days. 

Within 2 days patients have shared they are going about their everyday life pain-free and are typically back at work within the week.

Customer testimonials state, “I walked out of the facility with my wife. Walked. That surprised me”, “Had surgery within a week, I can put my socks on, clip my toenails, getting my 30’s back.” 

Patients are encouraged to use hot/cold packs if need be within the week of recovering and are not encouraged to lift anything over 20 pounds. Patients are also advised to contact the facility if any redness, swelling or pain occurs after the procedure. 

Benefits of laser spine surgery: 

• The precision laser technology creates a less-invasive procedure only focusing on the problematic tissue by gently moving healthy tissue aside. Patients leave with a minimal incision site of 4 millimeters. 
• Avoids collateral damage. The technology used in laser spine surgery purposely avoids damaging nerves, internal scarring and infection. 
• Has a short recovery period. Unlike most fusion or implant surgeries, laser spine surgery allows patients to walk out of the institute one hour after their procedure. Many patients state they were back to their everyday lives pain-free within one week. 
• Deuk laser disc repair has a 95% success rate in eliminating pain, with 0 complications and infections. The minimal, non-invasive procedure leaves little room for potential disruption of nerves and healthy disc tissue virtually eliminating the possibility of complications. 
• A 4-millimeter incision site leaving no scarring and can be covered with a bandaid. Unlike other procedures, deuk laser disc repair does not enter through the stomach to get to the spine, but on the back to avoid agitating organs and reduces the risk of infection.

Risks of laser spine surgery: 

• A risk of deuk laser disc repair is having an inadequate surgeon uninvested in the patient. The procedure is one of a kind, developed from years studying emerging surgical technologies, therefore you need an experienced, educated surgeon who is confident in the outcome. 

Cost: Request a free MRI review for a quote

Where to get it: Deuk Spine Institute

(Offered at Deuk Spine Institute) 

Different types: 

1. Anterior Cervical Discectomy and Fusion (ACDF) 
   1. The purpose of a discectomy is to relieve compression of the nerves that are causing pain. An ACDF is a neck surgery where the surgeon approaches the spine through the anterior (front) of the patient’s neck, removes the damaged spinal disc, and fuses vertebrae with a metal plate to alleviate pain.
2. Posterior Cervical Discectomy and Fusion (PCDF) 
   1. A procedure identical to an ACDF but the surgeon reaches the spine using a posterior (back) technique through the back of the patient's neck and uses screws and rods to facilitate spinal fusion.
3. Transforaminal Lumbar Interbody Fusion (TLIF)
   1. This lumbar (lower spine) fusion is a procedure through the posterior (back) of the spine. An interbody fusion spacer (a tool creating space for the insertion of a bone graft) is inserted between the disc space on the spine. In this disc space, a bone graft is placed. Over time the bone graft will fuse the vertebrae above and below together creating a singular bone from two adjacent vertebrae.
4. Extreme Lateral Interbody Fusion (XLIF) 
   1. The surgeon completes this lumbar spine fusion by reaching the spine from the patient’s side, as opposed to the front (anterior) or back (posterior). Once the surgeon has reached the spine, the problematic intervertebral disc space is located and a fusion is completed. This specific technique is recommended for those with lumbar spinal disorders such as scoliosis and spondylolisthesis.
5. Anterior Lumbar Interbody Fusion (ALIF) 
   1. A technique where the surgeon uses an anterior (through the abdominal region) entry to fuse the lumbar spine vertebra. Usually, this technique is used when multiple spinal vertebrae are being fused. Surgeons may also perform a posterior decompression (laminectomy). This surgery has been reported to be the most risky for complications of all the lumbar fusion techniques.

What it is: 

During any spinal fusion surgery, the surgeon permanently connects or fuses two or more vertebrae (the bones that make up the spine) together. When these vertebrae are fused they heal into a singular solid, long bone. This surgical technique was created to mimic the normal healing process of broken bones.

The spine consists of a disc space in the front and paired facet joints behind it; whenever you move your spine, these structures allow for the motion and cause pain. During a spinal fusion, vertebral segments are fused using a bone graft to stop the motion at one or more vertebra. When the bone is “fused” this means that the bone graft placed in between vertebras grows to join the two segments. Bone grafts are taken from the patient’s hip during surgery or can be taken from a cadaver bone or manufactured ahead of time. Unfortunately, bone grafts are common causes of unwanted spinal surgery complications.

The process of spinal fusion is when the surgeon places a bone graft between the problematic, pain-causing vertebrae and fuses the vertebrae to create a solid unit. This solid unit limits the motion of the pain-causing vertebrae. Metal plates, rods or screws may be used in the procedure to ensure correct bone graft growth and healing. Some techniques involve setting up a biological response to generate the growth of a bone graft between the vertebrae which creates a bone fusion over time.

Recovery time: 

It’s important to note the long recovery time when considering spinal fusion surgery. Patients should note that a bone fusion is not immediate; fusion of bones occurs when the bone graft placed during surgery eventually grows to form one bone. This process usually takes between 3-6 months. 

The first 1-3 months after surgery are critical in the healing process of a spinal fusion because the fusion is establishing. After roughly 6 months, patients can usually resume all normal activities if approved by their surgeon. Over the course of the year following this type of surgery the bone will continue to solidify. 

At Deuk Spine Institute spinal fusions are performed outpatient so patients are able to go home the same day. This is possible because of advanced techniques used permitting reduced blood loss and better pain control. At other facilities, patients will usually be released from the hospital within 2 or 4 days after surgery after being monitored for any complications or infections. After about a month, patients are encouraged to see a physical therapist to help reintroduce motion into their back. Normally, patients can resume driving, if off of opioid medications, after 4 weeks, and should be able to go back to office or sedentary jobs within 6 weeks

Benefits of spinal fusion surgery: 

• For fractures, fusion can add stability to the spine by fusing problematic vertebrae into one long, stronger bone. Fusion allows early remobilization of the patient who would otherwise be bedridden. 
• Reduces post-decompressive deformity to restore proper alignment of the spine. Abnormal alignment of the spine can lead to multiple procedures to fix other areas of the spine influenced by this misalignment. 
• Relieves spine pain by eliminating joints that cause pain. Spinal fusion is NOT a decompressive surgery so laminectomy may need to be done as well when nerves are pinched.

Risks of spinal fusion surgery: 

• The fusion may not take due to the lack of bone formation from the bone graft. In these cases, the bone graft put in place may not properly fuse the vertebrae together and the spine can remain unstable.
• May need additional surgery if the bone graft does not take, or if another spine area is affected by the fusion. 
• Infection, bleeding and blot clots are risks of any surgical procedure as serious as a spinal fusion. 
• Injury to blood vessels or nerves in and around the spine may occur since a spinal fusion is invasive. Nerves may be further damaged while placing the bone graft or metal implants in all types of spinal fusions. 
• Pain at the site of the bone graft may occur since the bone graft needs to be taken from the bone itself. 
• Screws used to anchor bones can become loose and erode surrounding bones or soft tissues.
• All spinal fusions are associated with substantial amounts of scar tissue and normal tissues get destroyed.

Cost: $60,000 - $500,000

Different Types: 

1. Laminectomy Surgery 
   1. During a laminectomy, the lamina is fully removed from part of the spine.
2. Laminotomy Surgery 
   1. During a laminotomy, the lamina is only partially removed from part of the spine. 

What it is: 

During surgery, the surgeon makes an incision on the patient’s back to access the problematic vertebrae. This procedure, sometimes referred to as “open decompression,” focuses on the lamina and attached ligaments, the part of the vertebrae that forms the vertebral arch in your spine found on the back (posterior) part of the bone to treat spinal stenosis. Once the surgeon has access to the vertebra, they remove the lamina and ligaments from the spine and any bone spurs or fragments that may also be pinching nerves. Unfortunately, laminectomy and laminotomy do not treat back pain or neck pain and frequently make back pain worse.

A laminectomy/laminotomy is usually completed to treat the symptoms of central spinal stenosis, a condition that narrows the spinal canal. The removal of the lamina from the vertebrae ultimately creates more space for the spinal cord and nerves from the narrowing caused by spinal stenosis. With the extra space allotted for the spine and with the removal of the source of pressure, patients will feel a decrease in their leg or arm symptoms but not back pain. The surgery usually takes 2-3 hours. 

During a laminectomy/laminotomy, it is common for the surgeon to perform a spinal fusion because of the instability the laminectomy causes. A bone graft is placed between vertebrae discs to fuse them together, forming a single, elongated bone. Laminotomy is always performed as part of a lumbar microdiscectomy to unpinch nerves to the legs.

Source: https://www.spine-health.com/

Recovery time: 

After laminectomy/laminotomy surgery, patients are able to leave the hospital after 2-4 days to ensure the lowest risk of complication or infection. Powerful pain-relieving medications and stool softeners are recommended by most surgeons the days following removal from the hospital. Scar tissue forms around the spine and nerves. 

During the first month at home, it is important to restrict intense exercise and activity to ensure stability in the spine while keeping in mind movement is beneficial to ultimately restore full movement. Patients will most likely see a physical therapist to assist in recovery that can take months or even years.

Patients may resume driving within 2 months after surgery if not taking opioid medications. Full recovery is dependent on the patient’s health before surgery, the procedure itself, and how the recovery went. Most patients experience a full recovery after 2-6 months of surgery and feel a small degree of newfound stiffness that lasts a lifetime. 

Benefits of laminectomy/laminotomy surgery: 

• Relief of pressure on the spinal cord and nerves decreasing and eliminating pain felt in the legs or arms. Back pain usually worsens permanently.
• Increased mobility by reducing pain caused by compression of spinal cord and nerves, allowing the spine more room.
• Reduced radiating nerve symptoms, eliminating the prickling sensations, numbness and tingling, and other problems including bladder issues. 

Risks of laminectomy/laminotomy surgery: 

• Collateral damage to surrounding tissues and nerves. A laminectomy/laminotomy is an invasive procedure that may damage surrounding tissues and nerves.
• Unsuccessful procedure resulting in back pain that persists after surgery and the need for further treatments. 
• A cerebrospinal fluid leak occurs due to a tear of the dura mater, the membrane surrounding the spinal cord. 
• Infections, excessive bleeding and the need for blood transfusion. 
• All laminectomies result in severe postoperative pain that necessitates the use of addicting opioid pain killers for prolonged periods of time.

Cost: $50,000 - $150,000

What it is: 

The spinal cord runs through the spinal column which is made up of vertebrae. The vertebrates found in the spinal column are in place to protect the cord and nerves from injury. Discs can be found between each vertebra to reduce rubbing and provide support. Over time these discs can become injured with annular tears and weaken due to age or injury which causes the soft inner part of the disc to bulge out, creating a herniated or bulging disc. When a disc becomes herniated, it can press on the spinal nerves and cause leg and back pain. 

A discectomy surgery aims to take the herniated part of the damaged disc, easing pressure on the nerves. The surgeon does this by accessing the spine through the patient’s back (posterior). Using various tools, the surgeon cuts through tissues surrounding the vertebra and removes the herniated part of the disc. A discectomy is commonly performed on the lumbar (lower) spine and relieves leg pain the patients may be feeling as a result of a herniated disc. This procedure does not help back pain and frequently makes it permanently worse.

A discectomy means “cutting out the disc”, within one procedure patients can have one (single-level) or multiple discs (multi-level) removed. “Levels” refer to different vertebrae. A discectomy is performed using an “open” technique. With this technique, the surgeon creates a larger incision to see the spine directly, which is more invasive than the minimally invasive approach (see Microdiscectomy). 

Recovery time: 

Patients will usually be hospitalized for the days following the procedure to ensure minimal risk of infection and complications. Leg pain should immediately cease in herniated disc post-surgery, but patients may confront discomfort and soreness from the incision spot and spinal nerve. 

Patients are expected to return to desk work within 3-4 weeks, and heavy lifting jobs within 8-12 weeks. Surgeons may prescribe physical therapy to help with gaining full movement back to the spine. 

Benefits of discectomy surgery: 

• Treatment of pain, numbness, weakness and tingling feelings in the leg caused by a herniated disc. 
• Removal of the problematic herniated disc, reducing chances of it reoccurring. 

Risks of discectomy surgery: 

• Nerve damage to neighboring nerves found in the spinal cord. Chance of nerve damage from tools and incision used during surgery. 
• Persistent pain if the herniated disc is not properly removed. 
• Cerebrospinal fluid leak, a complication that can damage nerves. 
• Bleeding/Infection/Blood clots, all of which are normal risks taken when having any medical procedure done. 
• Back pain gets worse. Spine becomes more unstable from bone, facet joint and ligament removal.
• Muscle damage from the surgery.

What it is: 

A mircodiscectomy surgery is similar to a discectomy surgery, although it uses a smaller skin incision and a microscope. It is usually recommended for those suffering from sciatica, a condition caused by compression of spinal nerves.

This technique is considered when patients feel pain or numbness from a herniated disc that puts pressure on the spinal nerve. A herniated disc is when the soft, inner tissue of the discs found in vertebrae bulges out through an annular tear, which ultimately puts pressure on nerves in the spinal column. 

The technique surgeons use during a mircodiscectomy aims to remove the disc material that has leaked and is putting pressure on surrounding nerves. During the procedure, the surgeon makes a small 1-2 inch incision on the patient’s back above the herniated disc spot. After cutting the muscle away from the spine, the surgeon removes bone and ligaments from the spine to get access to the herniated disc material. Unfortunately, part of a spinal facet joint must also be removed and this leads to the greatest amount of spinal instability. Spinal instability magnifies back pain and eventually patients require a second procedure like fusion.

Once the herniated disc material is removed, the pressure on the surrounding nerves is relieved. The surrounding nerves return to having the appropriate amount of space within the spinal column, and patients should no longer feel pain or numbness in their leg.

Recovery time: 

A minimally invasive discectomy technique is usually performed as an outpatient procedure, meaning patients return home the same day. Since a minimally invasive technique requires only a small incision, recovery time will be faster than if a patient is recovering from an “open” technique.

 Pain in the leg should immediately cease in herniated disc post-surgery, but patients may experience discomfort and soreness from the incision spot. Patients are told to avoid driving, sitting for prolonged periods, and lifting anything heavy for the first 1-2 weeks. Surgeons may prescribe physical therapy to help patients regain full movement of the spine. Full recovery for most patients is roughly 6 weeks to 3 months.

Benefits of mircodiscectomy surgery: 

• Patients should feel immediate relief of leg pain once the pressure is removed from the surrounding nerves. Often patients walk out of the procedure and are home within the same day. 
• Using a minimally invasive technique leaves patients with a 1-2 inch incision site. The technique also limits the disruption of surrounding nerves and tissues. 
• Patients regain the ability to move freely without leg pain and return to everyday life. 

Risks of mircodiscectomy surgery: 

• Possibility of a recurrence of a herniated disc. The surgery does not guarantee nor prevent other herniated discs in the future. 
• Cerebrospinal fluid leak, a complication that can damage nerves.
• Nerve damage to neighboring nerves found in the spinal cord. Chance of nerve damage from tools and incision used during surgery. 
• Bleeding/Infection/Blood clots, all of which are normal risks taken when having any medical procedure done. 
• Worsening back pain typically occurs. Spinal instability is a frequent consequence of this surgery because of the need to remove bone, joint and stabilizing ligaments.

What it is:

Located in the pelvis the sacroiliac joint, commonly called the SI joint, links the iliac (pelvic) bones to the sacrum (the lowest part of the spine located above the tailbone). This specific joint is responsible for shock absorption, making sure impactful forces do not reach the spine. The sacroiliac joint can be injured and/or deteriorate over time which causes pain in the buttocks, low back and legs. The SI Joint is an uncommon but important cause of pelvic and lower back pain. Prior to any surgery, injections and therapy should be tried as they result in pain resolution 90% of the time if done properly.

During a sacroiliac joint surgery, the patient lays face down and the surgeon makes a small, minimally invasive incision on the side of the buttocks. A bone graft is placed between the ilium and sacrum with the intention of the graft growing to connect the two bones. By connecting the bones together the patient will be relieved from pain caused by the joint. 

The bone graft used is usually taken from the hip bone during surgery. The bone graft does not automatically fuse the bones together; over time will grow to create one, immobile joint. Once the procedure is complete, the bone graft will continue to solidify for upto 12 months after the procedure but patients will feel immediate relief. 

Recovery time: 

Patients who undergo SI fusion surgery are usually cleared to go home the same or next day after the procedure. On the days following the procedure the patient may feel some pain from the incision or bone graft site, in this case, surgeons recommend icing the area and taking pain medication. Patients will be up and walking within hours usually with the help of a cane or walker. Within a month following the surgery it’s expected that patients should be able to walk around freely. 

Surgeons may prescribe physical therapy a month after to ensure the proper fusion of the joint. Patients should avoid heavy lifting, or strenuous activity for at least 3-4 months after and then after consulting with a surgeon. Within 6 months patients should be fully back to living their normal lives. 

Benefits of SI surgery: 

• Stabilizing the SI joint reduces pain and increases stability 
• The minimally invasive technique leaves patients walking within hours of the surgery, and are least likely to confront infection.
• Short operating time and minimal tissue displacement during surgery, resulting in an easier, quicker recovery period  

Risks of SI surgery: 

• Failure to fuse properly, the bone graft may not take to the joint, therefore failing to connect the joint. 
• Adjacent segment disease, which happens after the procedure when the pressure that has been relieved from the joint transfers to other areas in the pelvis.
• Bleeding/Infection/Blood clots are common risks taken with any surgical procedure. 
• Fractures of the pelvis.

What it is: 

A procedure recommended for patients who are suffering from reoccurring back pain for 6 months or longer, who find no relief in other non-surgical procedures. Patients who have tried physical therapy, medications etc. and still feel unremitting back pain usually consider artificial disc replacement. During an artificial disc surgery, the surgeon removes the disc that is causing pain and replaces it with an artificial replacement. 

The spine includes a series of vertebrae that are separated by intervertebral discs. These discs allow for movement in the spine and protect the vertebra from rubbing against each other. Over time, discs can become damaged or begin to deteriorate, causing back pain. When discs become unable to support the vertebra, the surgeon may recommend the placement of an artificial disc. 

The procedure removes the damaged or deteriorated disc and replaces it with an artificial disc designed to mimic the disc’s natural movement. Surgeons reach the spine through the anterior (front) of the patient through the abdomen, moving aside organs. This is generally regarded as the most risky and dangerous approach to the spine because of the severe complications known to occur with this type of surgery. Once the surgeon has reached the spine, they are able to remove the damaged disc and replace it with an identical artificial disc. 

Recovery time: 

Following an artificial disc replacement, patients should expect to stay in the hospital for 2-3 days before returning home. Patients will be up and walking within 24 hours of surgery. The benefit of the artificial disc is that there is no new bone that needs to heal; therefore patients should have full mobility of their mid-section. 

Patients should perform basic exercises and return to work after the first 6 weeks of surgery. Surgeons advise avoiding any movement that may cause hyperextension of the back and will most likely prescribe physical therapy.

Benefits of artificial disc: 

• Relief of pain caused by a damaged spinal disc. The removal of the problematic disc and replacement of an artificial one can relieve pain between the vertebrae. 
• Patients experience an improved range of motion and flexibility due to each vertebra having the freedom to move independently.
• Reduced damage and pressure on other discs. The placement of an artificial disc helps adjacent discs by relieving stress felt by the damaged disc. 

Risks of artificial disc: 

• Dislocation of the artificial disc may occur. This happens when the artificial disc becomes dislodged between the vertebrae. 
• Infection of the disc may occur in days following the placement. 
• Implant loosening or experiencing weakening wear over time, could lead to additional procedures. 
• Bleeding/Infection/Blood clots are common risks taken with any surgical procedure. 
• Injury to large blood vessels could cause a need to amputate the leg.
• Bowel injuries have occurred and require bowel surgery. Scar tissue from these invasive treatments can also cause blockages of the bowels, a life threatening problem.
• Many artificial disc surgeries have been proven to cause the fusion of spinal bones because of the severe trauma to the spine from the implantation of the artificial disc.