The spine does two jobs. It holds the body up and lets it move, and it protects the spinal cord running through its center. This guide covers the 5 regions of the spine, what a vertebra is made of, the discs and soft tissue, the spinal cord and nerve roots, why the spine curves, and how all of it connects to the words in an MRI report.

What Is the Spine? A Plain-English Overview of Spinal Anatomy

Put simply, the spine is a stack of bones reaching from the skull down to the pelvis. Try to name everything it does in a morning, and the list gets long fast. Sitting up in bed, tying shoes, checking a blind spot. All of that leans on the spine, and the whole time it’s also guarding the spinal cord tucked inside it.

Spinal anatomy gets easier once it’s split into four groups of parts. Bones come first, and doctors call them vertebrae. Discs are the cushions squeezed in between. A small facet joint on each side hooks one bone to the next, while ligaments, muscles, and tendons keep everything tied together.

The 5 Sections of the Spine (And What Each One Does)

The five sections of the spine run from the neck to the tailbone, and all five spine sections have their own letter code and job.

Cervical Spine (Neck)

Seven small vertebrae make up the neck, numbered C1 through C7. Together they balance a head weighing roughly 10 to 12 pounds. No other region moves as freely, and from the side, the neck bends slightly inward in what doctors call a lordotic curve.

Thoracic Spine (Mid-Back)

Drop down to the mid-back and the count jumps to 12, labeled T1 to T12. Ribs attach to each of these bones, so this stretch anchors the rib cage. That makes it the least mobile part of the spine, with a curve that bows outward, known as kyphotic.

Lumbar Spine (Low Back)

The low back runs on just 5 vertebrae, L1 to L5, but they’re the sturdiest in the stack because they carry most of the body’s weight. The curve here swings inward again, matching the neck’s lordotic shape.

Sacrum

The sacrum sits below the lumbar spine. It starts as 5 separate vertebrae, S1 to S5, which fuse during development. The sacrum connects the spine to the pelvis.

Coccyx (Tailbone)

The coccyx, or tailbone, is made of 4 small fused vertebrae. Several pelvic floor muscles and ligaments attach to it.

Added together, the running total is 7 + 12 + 5 + 5 + 4 = 33 vertebrae. This count is a basic part of the anatomy of the spine. In adults, the fused sacrum and coccyx are usually counted as one bone each, which brings the number of separate bones to 26.

What Are the Parts of a Vertebra? (Back Bones Anatomy)

Here’s the good news. Nearly every vertebra shares the same basic design, so once one makes sense, the rest follow. That’s really the core of back bones anatomy. And the names below? They’re the parts of the spine bones that keep popping up in doctors’ notes.

• Vertebral body: The solid front block that carries most of the weight.
• Vertebral arch: A curved ring of bone sitting behind the body. The spinal cord runs safely through its center.
• Pedicles and laminae: Pedicles are two short posts joining the arch and body. Laminae are flat plates closing the ring at the back.
• Spinous and transverse processes: The bony points sticking out backward and sideways. Muscles and ligaments grab on here.
• Facet joints: The spots where one vertebra touches the next. They guide movement and keep it from going too far.

Now stack those bones. The arches line up and create a tunnel, the spinal canal, where the cord runs. Along each side, gaps between neighboring vertebrae form small openings. Each one is called a neural foramen, and a nerve root slips out through it.

Why learn these two spaces? Because any “narrowing” on an MRI means one of them, either the canal or a foramen.

Discs, Joints, Ligaments and Muscles: The Soft Parts That Hold It Together

The spine may look like a stack of bones, but there is more to it. Between the vertebrae are soft discs that provide cushioning. Each disc has a strong outer layer, called the annulus fibrosus, and a softer center known as the nucleus pulposus.

These two parts work together whenever the spine moves. Walking, climbing stairs, or lifting a bag puts pressure on the discs. They compress slightly under that pressure and help keep the vertebrae from rubbing against each other.

Now move toward the back of the spine. On the left and right of each segment you’ll find a facet joint, and these two small joints glide against each other whenever the back turns. Twist too far and the joint surfaces butt up against one another, which keeps that segment from overrotating.

Holding everything in line are the ligaments, strong fibrous straps that run from bone to bone. Muscles handle the actual work of moving and keeping good posture, while tendons tie those muscles onto the vertebrae.

Cleveland Clinic counts this soft tissue among the five core parts of the spine. Discs and soft tissue also happen to be some of the most common sources of back pain, so these names show up constantly in conversations about sore backs.

The Spinal Cord and Spinal Nerves: What Each Level Controls

Think of the spinal cord as a two-way cable between the brain and everything below the neck. Stub a toe, and the pain signal races up the cord to the brain. Decide to pull that foot back, and the command rides the same cable down to the muscles. A few reflexes never reach the brain, since the cord handles them alone.

Oddly enough, the cord is shorter than the spine. It begins at the base of the skull and wraps up near the top of the lower back, around L1 or L2. On the way down, 31 pairs of nerve roots peel off and slip out through small gaps between the bones.

Because the cord quits early, the roots meant for the lower body have to keep traveling down the canal before they find their exit. Doctors named that trailing bunch the cauda equina, Latin for “horse’s tail,” and a drawing shows why. You’ll see the term in articles about spinal warning signs.

The roots divide up the body like this:

• Cervical roots: The shoulders, arms, and hands
• Thoracic roots: Bands circling the chest and belly
• Lumbar and sacral roots: The hips, legs, and feet

A pinched root usually makes itself felt wherever that root travels, not at the spine, so a neck problem can show up as tingling in the hand.

Why Does the Spine Curve?

Viewed from the front, a healthy spine looks straight, but a side view tells a different story. It bends into a gentle S shape made of three natural curves. The neck curves inward, which is called cervical lordosis. 

The upper and middle back curve outward in what’s known as thoracic kyphosis, and the low back curves inward again to form lumbar lordosis. These curves work together a lot like a spring. Each step sends a small jolt up through the body, and the alternating bends spread that force out rather than letting it travel straight up to the skull. 

They also keep the head balanced over the pelvis, a quiet but important part of the anatomy of the spine. Posture habits can gradually change the shape of these curves over the years, which is why curve changes sometimes appear on imaging reports.

How Spine Anatomy Shows Up in Your MRI Report

Most of the wording on an MRI report points back to the parts covered above. Take “L4-L5.” It names the segment between the fourth and fifth lumbar vertebrae, including the disc, joints, and foramina at that level, not a single bone.

Direction words each have a simple meaning:

• Anterior and posterior: Toward the front or the back
• Left and right: The patient’s own sides
• Central or foraminal: The middle of the canal, or the side opening

Common phrases decode the same way, as the table below shows. Remember, a report describes structures, not symptoms, and many findings appear in people with no pain at all. It’s a map of anatomy, not a diagnosis.

For a closer look at each term, see the guide to reading your MRI report. Anyone who wants their own scan explained can also request a free MRI review from some spine centers.

Which Part of the Spine Is Involved in Common Back Problems?

Most common back problems are named after the structure they involve. The map below simply pairs each structure with the conditions linked to it, and every condition has its own page with the full details.

• Disc: A herniation involves the intervertebral discs, specifically the gel-like center and the outer ring that surrounds it.
• Facet joints: Facet pain and facet arthritis both involve the small paired joints at the back of each spinal segment.
• Foramen or canal: A pinched nerve and spinal stenosis both involve these spaces, either the side doorway or the central tunnel.
• Nerve root: Sciatica and other radiating symptoms involve the nerve roots that branch off the spinal cord.
• Muscles and ligaments: A strain involves the soft tissue that supports and moves the spine.

FAQs: Spine Anatomy

What are the 5 sections of the spine?

The neck, mid back, low back, sacrum, and tailbone, also known medically as the cervical, thoracic, lumbar, sacral, and coccygeal regions. They are often referred to by doctors as C, T, L, S and Co respectively, hence their codes on scans.

What is the function of the spinal cord?

Mostly, it passes signals back and forth between the brain and the rest of the body. Reach for a hot pan, and the “that burns” message goes up the cord while “let go” comes back down, all in a split second. A handful of reflexes skip the brain completely.

How many bones make up the spine in total?

Thirty-three, if the fused ones are counted individually. That breaks down to 7 in the neck, 12 through the mid-back, 5 in the low back, 5 making up the sacrum, and 4 in the tailbone. Count the sacrum and tailbone as one bone each, and adults end up with 26.

What’s the difference between a vertebra and a disc?

A vertebra is one of the bones that make up the spine, while a disc is the soft cushion that sits between two vertebrae. Each disc has a tough outer ring and a gel-like center, which lets it absorb pressure and keep the bones from rubbing against each other.

What’s the difference between the spine and the backbone?

Nope, same thing. “Backbone” is what most people say at the kitchen table, while a doctor is more likely to write “spine,” “spinal column,” or even “vertebral column” in a chart.

Does the spine get shorter as people age?

A bit, for most people. Discs slowly dry out and get thinner over the decades, and those tiny losses at every level add up. The curves can change, too, and some people barely notice, while others lose a more noticeable amount.

What does “L4-L5” mean on an MRI report?

The space between the fourth and fifth bones of the low back. It covers the whole level rather than a single bone, so the disc, the joints on either side, and the nerve openings all fall under that one label. Think of it as an address that says where, not what’s wrong.

Conclusion

Spine terms look intimidating on paper. But each one points to a real structure, and none of them are hard to picture once the basics click. Regions, bones, discs, nerves, curves. Put those together and a report, or a doctor’s explanation, gets much easier to follow.

Knowing the anatomy of the spine also makes the next appointment more useful, since questions get sharper. Some spine centers offer a free MRI review, which gives people with an existing report a clear explanation of what it means.

Sources

updated: Sep 24, 2026

Medical disclaimer: This article is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Outcomes vary from patient to patient. Always consult a qualified healthcare provider about your specific spine condition before making treatment decisions.

Key Takeaways

• A laminectomy is a decompression surgery designed primarily for nerve-related symptoms (leg pain, numbness, walking difficulty), not for axial low back pain.
• A 2024 study found nearly half of veterans undergoing decompressive laminectomy failed to achieve functional improvement at 12 months. ²
• Post-laminectomy syndrome (failed back surgery syndrome) affects roughly 10%–40% of patients. ⁶
• Approximately 14% of laminectomy patients require reoperation within 5–10 years, most commonly for persistent back pain. ^3,4
• Deuk Laser Disc Repair® offers a minimally invasive, outpatient alternative that targets the actual pain generator without removing bone, cutting muscle, or implanting hardware. With a reported 99% pain relief rate for treated sources and a 0.01% complication rate across more than 2,800 procedures.

In case your surgeon has advised you to have a lumbar laminectomy for your spinal stenosis or herniated disc. It would be wise to know one particular fact about this surgical procedure. Though a laminectomy can significantly alleviate leg pain and neurogenic claudication in selected cases. An increasing amount of published research proves that a laminectomy has significant limitations in relation to axial pain, which is defined as the pain arising from the lumbar spine. ¹

What a Lumbar Laminectomy Actually Treats

In lumbar laminectomy surgery, there is removal of the lamina, which is the bony arch that lies at the back of the vertebrae to increase the size of the spinal canal hence reducing pressure on the compressed nerves. The lumbar laminectomy was meant to correct the neurologic symptoms associated with spinal stenosis, including pain, numbness, weakness, and difficulty walking long distances.

The challenge with this surgical procedure is that it was not meant to address the mechanical problems causing low back pain. In this procedure, dissection of the paraspinal muscles, removal of bone, and soft tissue manipulation take place, and this could affect the biomechanics of the spine in some patients.

Lower Success Rate Than Patients Believe Is Possible 

According to a study in the journal Frontiers in Musculoskeletal Disorders in 2024, close to half of the veterans that were treated using a decompressive laminectomy did not get any improvement after 12 months. ² This is an alarming statistic that poses tough questions regarding patient selection for the surgery.

A larger 2015 review of 500 laminectomy patients found that 14.4% required a second operation within an average of 3.4 years. ³ Patients who continued to have back pain after surgery carried a relative risk of reoperation 6.14 times higher than patients whose back pain resolved. Among those who ultimately went back to the operating room, back pain was the leading symptom reported by 54.17% of them.

The Evidence Base Is Thinner Than It Should Be

A systematic review of long-term laminectomy outcomes. Covering 12 studies and 83,492 patients with at least five years of follow-up. Concluded there is only low-quality evidence that patients experience durable improvement after the procedure. ⁴ The reoperation rate over 5–10 years was 14%. The reviewers pointed out that despite how common spinal stenosis is, high-quality long-term data supporting laminectomy remain surprisingly scarce.

Axial Back Pain: The Weak Point of Decompression Surgery

The most important limitation is this: laminectomy does not reliably treat axial back pain. Research on advanced pain management even notes that axial pain is “not as reliably treated” by decompression-based approaches. ⁵ That is because removing bone to make room for nerves does nothing about the degenerative disc, the arthritic facet joint, or the inflammatory cascade that is usually generating the actual back pain.

Post-Laminectomy Syndrome: A Common and Underdiscussed Reality

Failed back surgery syndrome sometimes called post-laminectomy syndrome. Refers to persistent or new pain after decompression surgery. National data suggest it affects between 10% and more than 40% of laminectomy patients, and up to 30–46% of those undergoing more complex multi-level procedures. ⁶

Why Laminectomy Fails

• The wrong pain generator was treated. The most common reason a laminectomy fails is that the anatomic lesion targeted by surgery wasn’t actually the source of the patient’s pain in the first place.
• Epidural fibrosis. Scar tissue is a normal part of healing, but excessive scarring around nerve roots can create fresh compression and new pain. ⁶
• Iatrogenic spinal instability. Removing bone (especially without fusion) can destabilize a spinal segment, producing ongoing mechanical pain and speeding degeneration of neighboring levels.
• Incomplete or recurrent disc herniation. Recurrent herniation affects 5–10% of patients, most often in the first three months after surgery.
• Adjacent segment disease (ASD). The stress and biomechanics that previously acted on the operative level are transferred to adjacent segments that may degenerate more quickly and need additional surgery.

Each of these mechanisms circles back to the same root issue: for most patients whose primary complaint is back pain, laminectomy is operating on the wrong anatomy. The structural reasons bone removal misses the true pain source run deeper than the headline failure rates suggest.

The Radicular vs. Axial Distinction Matters

In many cases, patients and even some surgeons do not seem to understand the difference between radiculopathy (leg pain because of compression of a nerve) and axial back pain (pain originating in the spine). Laminectomy was designed for the former and not the latter.

“Recently published meta-analyses suggest no statistically significant increase in spinal instability following laminectomy procedures; especially in patients without predominance of mechanical back pain symptoms.” ⁷ The obvious, but unspoken, implication is that laminectomy is the wrong surgery for mechanical back pain.

Complications You Should Know About

Apart from its efficacy, laminectomy presents clear surgical risks:

• Durotomy (tearing of the membrane around the spinal cord) happens in about 10% of cases.
• CSF leakage is observed in 1.6% of cases after the surgery.
• Infection, bleeding, and thrombosis persist as postoperative complications.
• Nerve injury may happen during decompression.
• Paraspinal muscle atrophy resulting from surgical injury leads to postoperative instability and pain.

Paraspinal muscle atrophy demands independent consideration. Open laminectomy surgery requires surgical separation and retraction of muscles, responsible for stability of your lumbar spine. This injury causes muscle atrophy and weakness. Moreover, it can cause chronic inflammation leading to pain even in cases when decompression itself was performed perfectly. Specific exercises can restore some functions, but the initial damage is done. ⁵

What Newer Research Suggests About Better Alternatives

A 2024 network meta-analysis in BMC Medicine compared surgical interventions for lumbar spinal stenosis and found that minimally invasive techniques (such as full-endoscopic laminotomy) reduce muscle damage and speed recovery. ⁸ But the analysis also highlighted a stubborn truth: most of these procedures still don’t directly address the discogenic and inflammatory drivers of back pain.

The pattern across the literature is consistent. The classic procedure of laminectomy often ends up exchanging one difficulty for another since it only provides symptomatic relief of the compressed nerves while failing to address the degenerative process itself, sometimes even speeding it up. This is precisely the area that new laser techniques have addressed.

Managing Expectations in the Age of AI

The problem of finding information about spine surgeries has become more complicated, rather than easier, with the advent of generative AI. The surgeons themselves always provide recommendations within the scope of their expertise. Asking a large language model for an answer leads to bias according to the way the question was phrased, the version of the model used, its training cut-off date, and its weighting of the web-based material.

The consequence of this is a misunderstanding of patient expectations when it comes to spine surgery and its results. People expect to feel decades younger after a laminectomy, something that is not even medically possible. If you have pain because of some secondary pathology, which is not addressed by the surgery, you might have a perfectly done procedure, yet still suffer.

What Revision-Surgery Data Reveal

Revision statistics are perhaps the most revealing indicator of laminectomy’s limits. In the 2015 series of 500 patients, 44.44% of those needing reoperation required decompression plus fusion, while 55.56% needed decompression alone. ³ The lifetime risk of eventually undergoing fusion after an index laminectomy was 8.0%. Meaning a meaningful minority of patients graduate to more invasive, higher-risk operations down the line.

A 2022 study looking at failed back surgery syndrome across procedure types found the highest rates in elderly patients (ages 70–74), those treated in inpatient settings, and those undergoing multi-level surgery. A profile that overlaps heavily with the typical open-laminectomy candidate. ⁹

Questions to Ask Before Agreeing to Surgery

A thorough workup should answer the following before you consent to a laminectomy:

• Is your dominant complaint back pain or leg pain?
• Are facet joint arthritis or degenerated discs contributing to your symptoms?
• Is there imaging evidence of spinal instability that bone removal might worsen?
• Have you truly exhausted conservative options: physical therapy, targeted injections, anti-inflammatories?
• Do you have realistic expectations about what surgery can and cannot achieve?

Proper patient selection is the single most powerful predictor of avoiding failed back surgery syndrome. Yet rising procedure volumes combined with financial incentives that reward more invasive surgery. Meaning laminectomies are still being performed on patients unlikely to benefit.

Why Traditional Laminectomy Persists Despite the Data

Open laminectomy remains one of the most commonly performed spine operations in the United States, and the reasons are as much economic as clinical. As detailed in analyses of the true cost of spinal fusion surgery, the spine industry has powerful financial incentives that favor invasive procedures: longer operative times, more implants, higher reimbursement. Even when less invasive alternatives may serve the patient better. ¹⁰

A Safer, More Minimally Invasive Alternative: Deuk Laser Disc Repair®

The fundamental problem with laminectomy is that it removes healthy bone and muscle to make more room for a nerve without ever touching the disc, annular tear, or inflammatory tissue that is actually generating your pain. Then the logical alternative is a procedure that does the opposite: leave the stabilizing anatomy intact and treat the pain generator directly.

That is precisely what Deuk Laser Disc Repair® (DLDR) was designed to do. Developed by Board-Certified neurosurgeon Dr. Ara Deukmedjian and refined over more than 20 years, DLDR is an endoscopic, laser-based procedure that targets herniated and degenerated disc tissue through an incision smaller than a dime: no lamina removed, no muscles cut, no hardware implanted, no fusion required.

How DLDR Directly Addresses What Laminectomy Cannot

Rather than increasing the space in the spinal canal and hoping the problem will resolve, DLDR involves a series of four precise steps:

1. Precision access through an incision no larger than 4 to 7 mm, less than the diameter of a dime. With use of a cylindrical dilator that slowly pulls apart muscles rather than cutting them.
2. Endoscopic viewing that allows the doctor to see the location of the annular tear and the extruded material of the disc millimeter by millimeter.
3. Treatment with the Holmium YAG laser that destroys only the diseased and painful tissue, the annulus and the herniated nucleus pulposus. Leaving the adjacent bone undisturbed.
4. The natural process of recovery over the next 9 to 12 months as the body heals itself.

This is all accomplished in just 20 minutes for each disc under light sedation at an outpatient facility. Blood loss averages 2 mL. Patients can walk within an hour, go home the same day, and resume normal activity within three days without opioids or narcotics.

Why This Matters Clinically

Every mechanism that drives post-laminectomy syndrome. Missed pain generator, epidural fibrosis from open dissection, iatrogenic instability from bone removal, adjacent segment disease from redistributed biomechanical load. Is either avoided or minimized by an approach that leaves the lamina, muscles, and ligaments intact and treats the disc pathology directly.

DLDR is not the right answer for every patient. It is specifically indicated for chronic discogenic pain stemming from herniated discs, bulging discs, degenerative disc disease, spinal stenosis, sciatica, and radiculopathy. Which is why an accurate diagnosis, based on a careful MRI review, is the essential first step.

Get a Second Opinion Before You Commit to Bone Removal

At Deuk Spine Institute, we believe patients deserve better than a default surgical pathway that fails a substantial share of the people it’s offered to. That starts with an accurate diagnosis of where your pain is actually coming from. Before anyone talks about removing bone.

Dr. Deukmedjian personally reviews every MRI to identify your specific pain generators and determine whether you are a candidate for Deuk Laser Disc Repair® or another minimally invasive option. There is no cost and no obligation.

Don’t let an outdated procedure and a rushed evaluation lead you down a path that research suggests fails nearly half the time.

FAQ

Does a lumbar laminectomy relieve back pain or only leg pain?

What is post-laminectomy syndrome and how common is it?

How is Deuk Laser Disc Repair® safer and less invasive than a laminectomy?

What are the alternatives to a lumbar laminectomy for back pain?

Sources

Medically reviewed on: September 22, 2026 

Medical Disclaimer: This article is for general educational purposes only and does not constitute medical advice. Consult a qualified physician for guidance specific to your condition.

Video Transcription

Key Points

✓ Assisted-dying laws fall into two broad models: one limited to the terminally ill, and one open to people with non-terminal but “grievous and irremediable” suffering.⁸

✓ In Canada, a natural death does not have to be foreseeable to qualify; these “Track 2” cases made up 4.4% of the 16,499 assisted deaths recorded in 2024.²

✓ Canada’s own expert panel confirmed that chronic pain conditions are not excluded from eligibility.⁴

✓ A United Nations committee and Canadian disability advocates have urged Canada to repeal Track 2, warning it offers death where it should offer support.^{5 6}

✓ In the United States, every assisted-dying law. Including California’s still requires a terminal diagnosis of six months or less, so chronic back or neck pain does not qualify.⁷

✓ The deeper issue for pain patients is the word “incurable.” Most chronic back and neck pain has an identifiable, treatable structural cause once it is diagnosed correctly.⁹

✓ Deuk Laser Disc Repair® treats back and neck pain from herniated discs by removing the damaged tissue at its source. With published outcomes averaging over 90% pain resolution, helping patients return to pain-free daily life.¹¹

Where this conversation is coming from

Over the last decade, medically assisted death has moved from the margins of medicine into mainstream law across much of the developed world. It now exists, in some form, in Canada, the Netherlands, Belgium, Luxembourg, Spain, Austria, Switzerland, every Australian state, New Zealand, and eleven U.S. jurisdictions.⁸ For a patient dying of an aggressive, untreatable cancer. Suffering with months to live and no realistic prospect of relief. The case for a peaceful, chosen death is one many thoughtful people find compelling.

But as these laws spread, the eligibility line has been moving. In some countries, you no longer have to be dying to qualify. You only have to be suffering in a way that is judged serious and irreversible. That shift is exactly where people living with chronic back and neck pain should pay attention. Not because anyone is being marched toward a clinic, but because of the quiet assumption buried inside these laws: that some pain is simply incurable, and that the reasonable response is to help the person end their life rather than end their pain.

Two very different models of assisted dying

It helps to be precise, because the public conversation often blurs together laws that are actually quite different. Researchers who compare these regimes internationally describe two dominant models.⁸

The distinction is not academic. Under the first model, a person with chronic back pain is legally nowhere near eligible, because chronic pain, however severe, is not terminal. Under the second model, the door is at least open and Canada has walked through it further than most.

What Canada’s law actually says

Assisted dying for medical reasons was legalized in Canada in 2016. In 2021, the government took away the need for the natural death of a person to be “reasonably foreseeable.”3 Today, for someone to undergo MAID (Medical Aid In Dying), they must suffer from a “grievous and irremediable medical condition” that is defined as “an incurable illness, disease or disability; an advanced state of irreversible decline in capability; and intractable and intolerable suffering that cannot be relieved under conditions he/she considers acceptable.”³

Cases where death is foreseeable are called “Track 1.” Cases where it is not the newer category are called “Track 2.” In 2024, Health Canada recorded 16,499 assisted deaths; Track 2 accounted for 4.4% of them.² A separate proposal to extend eligibility to people whose sole condition is a mental illness has been repeatedly delayed, and is currently postponed until March 2027.¹

So where does chronic pain fall? Notably, it is not carved out. Canada’s own federal Expert Panel on MAID and Mental Illness observed that “there are conditions that are not primarily within the domain of psychiatry, such as chronic pain conditions, that are not excluded” from eligibility.⁴ Health Canada’s monitoring data has likewise noted chronic pain among the conditions practitioners have listed in assisted-death declarations.⁴ In a suffering-based system, in other words, severe chronic pain that has been labeled incurable can put a person within reach of eligibility.

The alarm being raised and who is raising it

This is not a fringe worry. It is being voiced by disability-rights organizations, legal scholars, and international human-rights bodies. In March 2025, the United Nations Committee on the Rights of Persons with Disabilities reviewed Canada and recommended that it repeal Track 2, warning that making assisted death available to people whose deaths are not foreseeable risks discriminating against people with disabilities.^{5 6}

The core objection is about what a society offers people in distress. As University of British Columbia law professor Isabel Grant put it, when a non-disabled person wants to die, the system responds with suicide prevention and support; the concern is that Track 2 responds to disabled and chronically ill people with something else.⁶

Somebody else who wants to die, we offer them suicide prevention, we offer them supports. We don’t offer them death.

— Isabel Grant, law professor, University of British Columbia, on Track 2 MAID⁶

Advocates point to cases in which people appear to have chosen an assisted death not because their suffering was truly irremediable, but because the supports that could have relieved it. Adequate housing, income, home care, timely treatment were never provided.⁶ Reviewers have also noted that Track 2 recipients are disproportionately women with disabilities.⁶ The through-line of the criticism is simple: when the state finds it easier to approve a death than to fund a life, “choice” starts to look like something else.

What about the United States?

It is worth being clear-eyed here, because this is where public conversation often gets ahead of the facts. Some worry that the U.S. is on the verge of following Canada’s path that a state like California might soon extend assisted dying to people with chronic conditions like back pain. As of today, that is not what the law says.

California’s End of Life Option Act, like every other U.S. assisted-dying statute, requires a terminal disease with a prognosis of six months or less, confirmed by two physicians, with the medication self-administered by the patient.⁷ California’s law also states specifically that no one qualifies based solely on age or disability.¹⁰ Chronic back or neck pain. Which is not terminal does not meet that bar. The “slippery slope” from terminal illness to chronic pain is a genuine subject of debate, and reasonable people watch the trend in Canada with concern; but in the United States it remains a debate about the future, not a description of current law.

The other side of the argument

In fairness, supporters of these laws make a serious case, and it deserves to be represented honestly. They argue that mentally competent adults have the right to decide how much suffering they will endure. Multiple assessments, waiting periods, capacity evaluations are built into the process; and that in jurisdictions with decades of experience, they see a carefully governed medical practice rather than the abuses critics fear.¹⁰ The disagreement between these views is real, and it is not going to be settled in a spine clinic’s blog. What we can speak to is the medical premise underneath it all.

The premise worth challenging: “incurable”

Every suffering-based assisted-dying law rests on a medical judgment that a person’s condition is incurable and their suffering irremediable. For chronic back and neck pain, that judgment is often wrong not because the pain isn’t real, but because the underlying cause was never precisely identified or properly treated.

Most back pain is not even a surgical problem. The Mayo Clinic notes that the majority of back pain improves within about three months, and conservative care physical therapy, anti-inflammatory medication, targeted injections. Should almost always be tried first.⁹ But when pain persists for years and imaging shows a clear structural source that matches the symptoms, “incurable” is frequently the wrong label. It usually means the true pain generator hasn’t been found, or that the only treatments offered were the biggest and most destructive ones and were understandably declined.

At Deuk Spine Institute, the entire approach is built on diagnosis first. Dr. Deukmedjian personally reviews each patient’s MRI to identify the exact disc or nerve responsible for the pain before any treatment is discussed. When that structural source is found and treated directly, outcomes in our published case series have been strong: in long-term follow-up of lumbar Deuk Laser Disc Repair® patients, average reported resolution was 92% for lower back pain and 93% for radicular (nerve) symptoms, with same-day discharge and no complications recorded in that series.¹¹ Cervical and thoracic results in our published abstracts have been comparable.¹¹

These are outcomes from carefully selected patients with a confirmed discogenic pain source not a promise that every case can be resolved, and not a substitute for a real evaluation. But they make a point that matters enormously in this debate: for a great many people who have been told their spinal pain is permanent, that verdict deserves a second opinion before it is ever accepted as final.

The bottom line

The debate over assisted dying is a serious one, and the strongest version of every position deserves respect. Including the autonomy of a dying patient and the alarm of disability advocates alike. But for the specific population this clinic serves, one message stands above the policy argument: chronic back and neck pain is not a terminal illness, and in the great majority of cases it is not a life sentence either. Before anyone accepts that their pain is permanent and incurable, they owe it to themselves to be sure the diagnosis is right and the real options have been exhausted. Often, they have not been.

FAQ

Can someone qualify for assisted dying because of chronic back or neck pain? 

Does California’s End of Life Option Act apply to back pain?

Why did a UN committee ask Canada to repeal part of its MAID law? 

Isn’t there a legitimate case for assisted dying? 

Is most chronic back pain actually treatable? 

What is Deuk Laser Disc Repair, and what results does it report? 

Sources

Board Certified Neurosurgeon 

Medically reviewed on: September 17, 2026 

Medical Disclaimer: This article is for general educational purposes only and does not constitute medical advice. Consult a qualified physician for guidance specific to your condition. 

Key Points 

✓ Back surgery success rates range from 70% to 90% for properly selected patients. ²

✓ Failed Back Surgery Syndrome affects 10–40% of lumbar surgery patients. ³

✓ Second back surgeries succeed only about 30% of the time. ⁷

✓ Spinal fusion requires 6–12 months of recovery; minimally invasive procedures take 4–6 weeks. ²

✓ Deuk Laser Disc Repair® treats disc pain through a 4–7 mm incision: no fusion, no hardware, same-day discharge. ¹⁰

What Is Back Pain Surgery?

Back surgery for back pain includes any type of operation that is done on the spinal column in order to alleviate back pain, to release the pinched nerve roots, to stabilize the spine, or to correct a spinal deformity. Such surgeries can vary from simple surgeries that take up to an hour to perform to complicated operations lasting several days.

One of the basic objectives of back surgery is either decompression (releasing pressure on the spinal cord or nerve roots) or fusion (stabilization of the spine segment). ¹ In some cases, the surgeon performs both at once.

But what surgery cannot do is also very important to know. Back surgery alleviates the leg pain much more effectively compared to back pain since in most cases patients experience some kind of back pain even after the back surgery. That is why it is extremely important to identify the cause of the back pain prior to the operation. 1

When Is Back Pain Surgery Necessary?

Surgery is not the immediate solution in the treatment of back pain. From Mayo Clinic, most back pains resolve on their own after three months, with conservative methods being attempted first such as physical therapy, medicines, and steroid injections. ¹

Back surgery becomes an acceptable option when certain criteria are fulfilled. It involves the patient having tried conservative management options for six to twelve weeks without success. There is diagnostic proof through imaging (mostly MRI) of structural abnormality matching the patient’s symptoms. The pain is severe to the extent that it impacts one’s daily activities, work, or sleeping abilities. ¹

There are instances where there should be no delay in performing back surgery. They include when there is an emerging neurological deficit such as foot drop, weakening muscles, and cauda equina syndrome. Emergent cases involve loss of bowel or bladder control. There are patients with spinal instability, spinal metastasis, and spinal infections requiring immediate back surgery. ⁴

Indications for emergency assessment: When one has abrupt incontinence of urine or stool, rapidly progressing leg weakness, or numbness around the groin region along with back pain, then immediate medical help should be sought as these signs can be indicative of cauda equina syndrome.

Types of Back Pain Surgery

There exist several types of surgeries used in treating back pain, each of which is specifically used to solve a particular problem. The kind of surgery you are recommended to have is determined by the structural problem, the number of vertebrae affected, and your general health status.

Discectomy and Microdiscectomy

A discectomy removes the portion of a herniated disc that is pressing on a spinal nerve. The microdiscectomy variant uses a smaller incision and a surgical microscope or endoscopic camera, allowing the surgeon to perform the same procedure with less tissue disruption. Microdiscectomy is one of the most commonly performed and well-studied spine operations, and it is typically done as an outpatient procedure. ²

Laminectomy (Decompression)

Laminectomy is a surgical process where a part of the vertebra known as lamina is removed in order to provide additional space for the nerves and spinal cord. It is a common procedure for spinal stenosis. This is a condition where there is narrowing in the spine leading to pain and weakness in the legs. ⁴

Spinal Fusion

Spinal fusion permanently joins two or more vertebrae together using bone grafts and, in most cases, metal hardware such as rods, screws, and cages. The fused segment no longer moves independently. Fusion is used for conditions including degenerative disc disease, spondylolisthesis (where one vertebra slips forward over another), scoliosis, fractures, and spinal instability. Recovery from spinal fusion is longer than decompression alone, often requiring six to twelve months for the bone to fully heal. ²

Artificial Disc Replacement

Instead of fusing vertebrae, artificial disc replacement removes the damaged disc and inserts a prosthetic device that preserves motion at the treated level. This procedure may reduce the risk of adjacent segment disease. A condition in which the spinal levels above and below a fusion deteriorate more quickly due to altered biomechanics. Disc replacement is generally limited to patients with single-level disc disease who meet specific anatomical criteria. ²

Minimally Invasive Spine Surgery (MISS)

MISS employs small incisions, retraction tubes, an endoscope for visualization and special instruments to perform all of the surgeries listed above. This is achieved by accessing small pathways and not by opening up the surgical field, thus causing less damage to the muscle and soft tissue. In comparison to open surgery, patients undergoing MIS suffer from less pain and recover more quickly. 5 One of the more advanced forms of MIS is the Deuk Laser Disc Repair® technique that makes use of a Holmium YAG laser to repair discogenic pain directly through a 4 mm incision. ¹⁰

Success Rates by Procedure

Success rates for back surgery vary considerably depending on the procedure, the specific condition being treated, and how “success” is measured. In the clinical literature, success is typically defined as a meaningful reduction in pain combined with patient satisfaction at follow-up.

A prospective cohort study that tracked 486 patients after lumbar spine surgery found that 80.7% reported satisfaction with their outcome at twelve-month follow-up, and 59.6% met the study’s full definition of surgical success. Meaning they were both satisfied and had pain and disability scores below established thresholds. ⁶

The exact technique is important. Discectomy for a herniated disc that presses against a nerve enjoys some of the highest rates of success, with one big study of more than 39,000 people showing a success rate of 78.9% for lumbar herniation and 94% for cervical disc surgery. ⁷ Spinal fusion for degeneration succeeds about 70% to 90% of the time; however, outcomes are very dependent upon patient selection. Disc replacement surgery demonstrates very high success rates of 85% to 95%.  ²

These numbers reflect outcomes among patients who were carefully selected for surgery based on clear imaging findings that matched their symptoms. Patients whose symptoms visibly have structural issues. Such as a herniated disc compressing a specific nerve root can experience the most significant improvement. ²

Risks and Complications

There is always some level of risk involved with all surgical operations, and this includes back surgeries too. The most common risks associated with such surgeries include infection at the point of incision, clotting of blood, damage to nerves, excess bleeding, and side effects of anesthesia. The total percentage of risks involved in such procedures varies depending on the type of surgery. ²

Procedure-Specific Risks

There are specific risks involved in spinal fusion apart from those seen with decompression surgery. This is because spinal fusion involves changes in the mechanics of the spine; hence, adjacent vertebral segments undergo premature degeneration. This is called adjacent segment disease. Pseudarthrosis, or the failure of bone to integrate completely, occurs in some individuals, resulting in continued instability and pain. Complications with hardware include screw loosening, rod fracture, or migration of cages. ²

The results of a 2024 prospective cohort study involving 512 patients who had posterior open lumbar spine surgery revealed that the incidence rate of FBSS was 32.5% within one year of follow-up. It was determined that the surgical procedure was the best predictor of FBSS with pedicle screw fixation and posterior lumbar interbody fusion (PLIF) having higher incidences.  ⁸

Factors That Increase Surgical Risk

There are several variables that either can be changed or not and affect the probability of post-surgical complications. For example, obesity, active smoking, poorly managed diabetes, and lack of treatment for depression or anxiety have all been associated with higher probability of complications after surgery. ³ When one is contemplating undergoing surgery of the spine, it is advisable to consult his or her surgeon about these variables.

Failed Back Surgery Syndrome

Failed Back Surgery Syndrome, now formally redesignated as Persistent Spinal Pain Syndrome Type 2 (PSPS-T2), describes a condition in which patients continue to experience chronic pain after lumbar spine surgery. The term does not necessarily imply that the surgery itself was performed incorrectly. It can result from a range of causes including incomplete decompression, misdiagnosis of the original pain source, development of scar tissue around nerve roots, recurrent disc herniation, or progression of degenerative disease. ³

The prevalence of FBSS is significant. A 2025 multicentric retrospective review published in the Asian Journal of Neurosurgery placed estimates between 10% and 40% of all spine surgeries. ³ A separate 2024 multicenter study found that 15–20% of patients who underwent lumbar surgery experienced persistent or recurrent pain. ⁹

One of the most consequential findings in the FBSS literature is that repeat surgeries have progressively lower success rates. While the first back surgery may succeed in roughly 60–80% of carefully selected patients, a second operation on the same area succeeds only about 30% of the time, a third roughly 15%, and a fourth as low as 5%. ⁷ This steep decline underscores why the initial surgical decision and the diagnostic precision behind it is so important.

Recovery Timelines

Rehabilitation following surgery for the back involves factors like the kind of surgery that has been performed, the general well-being of the patient and his or her age and the method of treatment employed by the surgeon; open or minimally invasive.

Minimally invasive spine surgeries such as micro discectomy result in most patients being discharged from hospital the very same day and able to take part in light physical activity after two to four weeks, whereas full recovery may be attained after four to six weeks. ⁵

The healing process following open lumbar laminectomy surgery takes between six and twelve weeks but full recovery from this process usually takes up to three months, with minimal invasive procedures usually taking less time. The recovery period for spinal fusion surgery takes the longest amount of time. This process involves the first six to eight weeks of recovery where the patient wears a back brace and avoids bending and twisting. It also involves a minimum of six to twelve months to heal from the bone graft. ²

Role of Physical Therapy in Recovery from Back Surgery

The recovery process following back surgery needs physical therapy for the success of the operation. The program will help in increasing the strength, flexibility, and stability of the back.  ¹

Conservative Alternatives to Consider First

As back surgery entails certain risks and may not be successful in all cases, most clinical guidelines recommend exhausting conservative options before undergoing surgery. The only exceptions to this guideline are emergency situations like cauda equina syndrome and progressive neurological deficits.

Clinical evidence supports several conservative approaches to treating chronic back pain, including physical therapy that involves strengthening and stretching exercises, non-steroidal anti-inflammatory drugs (NSAIDs), epidural steroid injections for nerve root inflammation, cognitive behavior therapy to address chronic pain psychologically, and lifestyle changes, such as weight reduction and cessation of smoking. ¹

These approaches work well for the majority of patients. When they do not, and imaging confirms a structural problem that correlates with the symptoms, surgery becomes a reasonable next step rather than a first resort.

Deuk Laser Disc Repair®: A Minimally Invasive Alternative to Fusion

In cases where patients have persistent back pain or neck pain because of disc injury: disc bulge, disc herniation, degenerative disc disease, disc tear, spinal stenosis, sciatica, or radiculopathy .Deuk Laser Disc Repair® (DLDR) is essentially a very different procedure from that of traditional spine surgery. Instead of fusing the bones together or putting an artificial substitute in place of the disc, DLDR utilizes a Holmium YAG laser to excise the diseased portion of the disc that is causing the pain. ¹⁰

Developed by board-certified, fellowship-trained neurosurgeon Dr. Ara Deukmedjian and performed at Deuk Spine Institute in Melbourne, Florida, the procedure has been refined over more than 30 years and 2,800+ cases. ¹⁰

How the Procedure Works

The DLDR is a four-part outpatient surgery done under mild sedation. The whole procedure takes about 20 minutes per disc. ¹⁰

The first step involves making a very small 4-7 mm incision. The surgeon uses a cylindrical dilator to separate muscle tissues to form a channel to the damaged disc without having to cut the muscles or bone tissues. A tubular retractor is then placed over the dilator. ¹⁰

The next part is when an endoscopic camera is placed inside the retractor giving the doctor high resolution visualization of the disc’s internal environment. Using this visual information, the Holmium YAG laser will remove the painful, inflamed tissues of the disc. Specifically the torn annular fibers and the herniated nucleus pulposus. After removal of the inflamed tissues, the tools will be removed and the incision will be sewed up using a single suture. ¹⁰

Clinical Results

Dr. Deukmedjian has reported an average of 99% pain relief for treated pain sources across more than 2,800 procedures, with a complication rate of 0.01% and a 0% infection rate. Average blood loss during the procedure is less than 2 ml. ¹⁰

How DLDR Compares to Traditional Back Surgery

The differences between Deuk Laser Disc Repair® and conventional procedures such as spinal fusion or traditional discectomy are significant across several dimensions that matter to patients. ¹⁰

Who Is a Candidate for DLDR?

DLDR is designed for patients with chronic discogenic pain. Pain that originates from a damaged or deteriorating spinal disc. The procedure treats herniated discs, bulging discs, degenerative disc disease, spinal stenosis, sciatica, and radiculopathy in the lumbar (lower back), cervical (neck), and thoracic (mid-back) regions of the spine. ¹⁰

Candidacy begins with an accurate diagnosis. Dr. Deukmedjian personally evaluates each patient’s MRI to identify the specific “pain generators”. The exact discs and nerves responsible for the patient’s symptoms. This diagnostic precision is what enables DLDR to achieve its high success rate; the procedure works because the structural source of pain has been correctly identified and directly treated. Deuk Spine Institute offers a free MRI review to help patients determine whether they are candidates. ¹⁰

How to Choose a Spine Surgeon

The surgeon’s experience, training, and approach to diagnosis are among the most important variables in surgical outcome. When evaluating a spine surgeon, consider their board certification in orthopedic surgery or neurosurgery, their volume of procedures specific to your condition, and whether they take the time to explain both surgical and nonsurgical options before recommending an operation. ²

A second opinion is always reasonable and often valuable when surgery is being recommended. A quality spine surgeon will support rather than discourage this step, because accurate patient selection is in everyone’s best interest.

FAQ

What is the success rate of back pain surgery?

What helps nerve pain in legs after back surgery?

How do I know if I need back surgery or physical therapy?

What is the most common type of back surgery?

What is failed back surgery syndrome?

What is Deuk Laser Disc Repair® and how is it different from spinal fusion?

Is minimally invasive spine surgery better than open surgery?

Sources

Not every hardware failure looks the same. Some patients notice something is wrong within weeks of surgery. Others don’t find out until a routine X-ray, years later, catches a broken screw they never felt. And the standard fix, more fusion hardware at more levels, carries its own complication: it can accelerate adjacent segment disease, the same process that may have contributed to the original failure.

If you had a fusion and are now facing a second procedure to address loose or broken hardware, it’s worth knowing that another fusion is not automatically your only path forward. Deuk Laser Disc Repair® treats many of the underlying disc and nerve problems fusion was originally meant to solve, without hardware, without bone drilling, and without adding a new segment to fuse. A Free MRI Review can tell you whether that’s realistic for your specific case before you commit to more metal.

No cost · No obligation

Learn How You Can
Live Pain Free

Upload your MRI for a free expert review by Dr. Ara Deukmedjian, M.D. —
board-certified neurosurgeon. Ten minutes can change your life.

Submit My MRI — It’s Free

2,750+ Deuk Laser Disc Repair procedures

0 complications

99.6% pain relief

What Is Spinal Fusion Hardware Failure?

Spinal fusion hardware failure is the loosening, breaking, or migration of the pedicle screws, rods, plates, or interbody cages used to stabilize the spine during a fusion procedure. It is one of the most common reasons patients require a second spine surgery.

During a fusion, hardware acts like an internal cast. It holds two or more vertebrae rigidly in place while a bone graft grows across the space between them, a process called arthrodesis. Once solid bone has formed, the fusion mass, not the metal, is what actually stabilizes the spine.

The problem is that solid bone formation takes time, typically six to twelve months, and in a meaningful percentage of patients it never fully happens. When the bone doesn’t unite, the hardware is left doing a permanent job it was only designed to do temporarily. Under years of daily mechanical load, that’s when screws loosen and rods fatigue and crack.

What Causes Screws, Rods, and Cages to Fail?

Hardware fails for one of two underlying reasons: the bone never solidly fused around it, a condition called pseudarthrosis, or repeated mechanical stress fatigues the metal until it loosens or fractures.

Several factors make either outcome more likely:

• Osteoporosis or osteopenia, which reduces how firmly a screw can grip bone
• Diabetes, which is associated with higher rates of pedicle screw loosening
• Smoking, which significantly impairs bone graft healing
• Multi-level fusion, which places more mechanical demand across more hardware
• Obesity or high-impact activity resumed before the fusion has matured
• Infection at the surgical site, which can weaken the bone-hardware interface
• Poor screw-to-pedicle sizing at the time of surgery

Published research puts this in context. A 2025 systematic review and meta-analysis found an aggregate pedicle screw loosening rate of 23.8 percent after lumbosacral fusion, with individual study rates ranging from roughly 15 to 42 percent.¹ In patients with osteoporosis, some studies report loosening rates as high as 60 percent, compared to under 15 percent in patients with healthy bone density.²

What Are the Symptoms of Failed Spinal Hardware?

The clearest symptom of failed spinal hardware is a return of the same pain the fusion was supposed to fix, sometimes alongside new symptoms at a different level of the spine.

Other signs to watch for include:

• Crepitus, a grinding, popping, or scraping sensation when you move
• A visible or palpable bump near the incision where hardware has shifted outward
• New numbness, tingling, or weakness radiating into an arm or leg
• Back spasms or nerve irritation not present earlier in recovery
• Pain that disrupts sleep or worsens with specific movements or positions

Some patients feel none of these symptoms at all. Hardware failure is sometimes discovered only on imaging obtained for an unrelated reason, which is why routine follow-up X-rays remain important even after you feel fully recovered.

How Soon After Surgery Does Hardware Failure Happen?

Hardware failure can appear within the first year after surgery or emerge gradually over many years, and the timing usually points to a different underlying cause.

Early failure, typically within the first six to twelve months, most often signals that the bone graft hasn’t fused yet. Radiolucent zones, a subtle sign of loosening visible on imaging, have been documented in over 40 percent of patients as early as six months postoperatively, though a portion resolve on their own as fusion progresses.³

Late failure, occurring years after surgery, is more often mechanical fatigue: metal that has held steady for a long time finally cracks under repetitive daily stress, sometimes at the exact level where a solid fusion never fully matured underneath it.

How Is Hardware Failure Diagnosed?

Hardware failure is diagnosed through a combination of your symptom history, a physical exam, and imaging that directly visualizes the screws, rods, or cages.

1. X-ray: Usually the first step, often able to show a broken rod, a displaced screw, or a radiolucent zone around a loosening implant
2. CT scan: Provides a more detailed cross-sectional view when X-ray findings are unclear or subtle
3. MRI: Evaluates the surrounding soft tissue, nerves, and disc levels, particularly useful if new radiculopathy is present
4. Physical and neurological exam: Checks for loss of sensation, weakness, or reflex changes that correlate with the imaging findings

If infection is suspected alongside hardware failure, bloodwork and sometimes fluid sampling are added to rule out a deep implant infection, which can itself cause screws to loosen.

What Happens Next? Your Treatment Options After Hardware Failure

What happens after a confirmed hardware failure depends on whether the bone has fused, whether you’re in pain, and how much of the original hardware is affected.

Broadly, patients fall into three paths:

• Conservative management: If the fusion is otherwise solid and pain is mild, some surgeons monitor loose hardware with periodic imaging rather than operating immediately, particularly if the loosening is not causing nerve compression
• Revision surgery: Broken or symptomatic hardware is typically removed and replaced, sometimes with larger screws, added cross-bracing, or bone graft augmentation to encourage the fusion to finally solidify
• Extended fusion: If the original levels never fused and adjacent segments have also degenerated, the fusion may be extended to additional vertebrae, which brings its own risk of accelerating problems at the new adjacent levels

This is the part patients are rarely told clearly beforehand: fixing failed fusion hardware very often means adding more fusion, not less, and each added level compounds the long-term motion loss that the original surgery already introduced.

Does Failed Hardware Always Mean More Fusion?

No, failed hardware does not always mean you need another fusion. Whether it does depends on why the original surgery was performed and what’s actually generating your current pain.

If your original fusion was done to treat a herniated disc, foraminal stenosis, or discogenic pain rather than true spinal instability or a fracture, it’s worth having your imaging reevaluated before agreeing to more hardware. In many of these cases, the structural pain generator, the disc or nerve tissue itself, can be addressed directly.

Deuk Laser Disc Repair® is a motion-preserving alternative that treats the disc and nerve pathology through a small incision, without bone drilling, screws, rods, or a new segment added to your fusion construct. It won’t apply to every failed hardware case, particularly where true structural instability exists, but it’s worth ruling out before you agree to extend the fusion further. Our guide to pain after spinal fusion walks through how we evaluate cases like this.

Can Spinal Hardware Failure Be Prevented?

Spinal hardware failure can’t be eliminated entirely, but several factors within your control meaningfully reduce the risk.

• Addressing bone density before surgery, since osteoporosis is one of the strongest predictors of screw loosening
• Quitting smoking well before and after surgery, since nicotine significantly impairs bone graft healing
• Following activity restrictions during the six to twelve month fusion window, even once pain has improved
• Managing diabetes and other conditions that affect bone healing
• Choosing a surgeon and facility with strong published fusion and complication rate data

None of these guarantee a solid fusion, since a meaningful percentage of hardware failure is tied to factors beyond patient control, including how much mechanical stress a given fusion construct is placed under.

Bottom Line

Loose screws and broken rods after spinal fusion are common, not rare, and they usually show up as a return of your original pain, a grinding sensation, or a visible bump near the incision. Diagnosis starts with an X-ray and often moves to CT or MRI. Treatment ranges from monitoring to revision surgery to an extended fusion, and it’s worth confirming what’s actually generating your pain before assuming more hardware is the only answer.

Frequently Asked Questions

How common is spinal fusion hardware failure?

Spinal fusion hardware failure is relatively common, with published research placing pedicle screw loosening rates at roughly 24 percent on average across lumbosacral fusions, and as high as 60 percent in patients with osteoporosis.

Can a broken rod in your back be fixed without surgery?

A broken rod in your back generally cannot be fixed without surgery once it is fractured, though a surgeon may recommend monitoring rather than immediate revision if the surrounding fusion is stable and you are not in significant pain.

What does hardware failure feel like after spinal fusion?

Hardware failure after spinal fusion often feels like a return of your original back or neck pain, sometimes paired with a new grinding or clicking sensation, spasms, or numbness and tingling radiating into an arm or leg.

How long do spinal fusion screws and rods last?

Spinal fusion screws and rods are designed to remain permanently in the body, but their mechanical job is meant to end once solid bone fusion occurs, typically within six to twelve months. Hardware that is still bearing full load years later, because fusion never solidified, is more prone to eventual failure.

Does removing spinal hardware fix the pain?

Removing spinal hardware fixes the pain in many cases where the hardware itself, rather than the underlying condition, is the source of symptoms, such as a painful prominent screw or broken rod. It does not resolve pain caused by a separate issue like adjacent segment disease or an unaddressed disc problem.

Is a second fusion the only option after hardware failure?

A second fusion is not always the only option after hardware failure. If the original fusion was performed for a disc or nerve problem rather than true instability, a motion-preserving alternative such as Deuk Laser Disc Repair® may address the underlying cause without adding more hardware.

Can spinal hardware failure be an emergency?

Spinal hardware failure can be an emergency if it causes sudden new weakness, loss of bladder or bowel control, or rapidly worsening neurological symptoms, in which case you should seek immediate medical care rather than waiting for a routine follow-up appointment.

---

Diagnosis. Answers. Relief.

FREE Virtual Consultation + MRI Review

Submit your MRI for a free expert review by Dr. Ara Deukmedjian, M.D. —
board-certified neurosurgeon. No obligation. Real answers.

Schedule Yours Today

2,750+ Deuk Laser Disc Repair procedures

0 complications

99.6% pain relief

Medical Disclaimer: This content is for educational purposes only and does not constitute medical advice. Individual results vary. Always consult your healthcare provider about your specific condition and treatment options.

References:
1. S1 Pedicle Screw Loosening: A Systematic Review and Meta-Analysis of Risk Factors and Outcomes, PMC
2. Incidence, Risk, and Outcome of Pedicle Screw Loosening in Degenerative Lumbar Scoliosis Patients, Global Spine Journal
3. Initial Appearance and Temporal Distribution of Pedicle Screw Loosening After Single-Level Lumbar Interbody Fusion, PMC

It is a fair question, and most patients do not get a straight answer to it. They hear “fusion” and picture bones growing back together on their own. What actually happens is that a surgeon opens the spine, drills into the bone, and permanently implants metal hardware to hold two or more vertebrae in place while the bone tries to fuse around it. The hardware does not come back out. It stays in your spine for the rest of your life.

As a board-certified neurosurgeon who has spent my career developing an alternative to this exact procedure, I think patients deserve to know precisely what “fusion” means in physical terms before they consent to it.

---

Diagnosis. Answers. Relief.

FREE Virtual Consultation + MRI Review

Submit your MRI for a free expert review by Dr. Ara Deukmedjian, M.D. —
board-certified neurosurgeon. No obligation. Real answers.

Schedule Yours Today

2,750+ Deuk Laser Disc Repair procedures

0 complications

99.6% pain relief

The Three Things That Get Implanted

Every instrumented spinal fusion involves some combination of the following three components.

Pedicle screws. These are threaded screws, typically made of titanium alloy or, less commonly, stainless steel, that the surgeon drives directly into the pedicles, the narrow bony columns at the back of each vertebra. A typical fusion uses at least four screws, two per vertebra being fused, though multi-level fusions require far more.

Rods. Once the screws are in place, the surgeon connects them with metal rods, usually titanium, cobalt-chromium, or occasionally a nickel-titanium alloy called nitinol. The rods span the screws like a bridge, locking the vertebrae into a fixed position relative to each other.

Interbody cages. In many fusions, the surgeon also removes the damaged disc entirely and replaces it with a cage, a small hollow device made of titanium, carbon fiber, or a medical plastic called PEEK (polyetheretherketone). The cage is packed with bone graft material and acts as a spacer that is meant to encourage new bone to grow through it and fuse the two vertebrae together.

Depending on the surgical approach, cross-links, plates, or hooks may be added to the construct as well. All of it is designed to do one job: eliminate motion at that spinal segment permanently.

Why Surgeons Use Hardware in the First Place

Fusion surgery works on a simple mechanical idea. If a segment of your spine is unstable, painful, or degenerated, locking it in place should stop it from moving and, in theory, stop it from hurting. The hardware is not the fusion itself. It is scaffolding. The screws, rods, and cage hold the vertebrae rigidly still while your body attempts to grow new bone across the joint over several months. Once that bone bridge forms (if it forms), the hardware becomes largely redundant. But it is virtually never removed, because a second surgery to take it out carries its own risks with little clinical benefit.

That last point matters more than most patients realize going in. As one instrumented fusion overview puts it, the metal bridge gives your spine immediate strength, but it is a temporary solution wearing a permanent one’s clothes: the hardware is never as strong on the day of your five-year follow-up as it was on the day it was implanted.

What This Actually Means for Your Spine Long Term

This is the part patients are rarely told in the consultation room.

The segment above and below the fusion now absorbs more stress. Your spine moves as a connected chain. When one or more segments are locked rigid, the segments directly above and below have to compensate for the motion that used to be shared across more of the spine. Over years, that added mechanical load accelerates wear on those adjacent discs and joints. This is the mechanism behind adjacent segment disease, one of the most common reasons fusion patients end up needing a second surgery.

Hardware can loosen, break, or migrate. Screws can back out of bone that has not fused solidly. Rods can fatigue and fracture under years of repetitive load, particularly at spinal levels that see constant motion. When this happens, it typically requires revision surgery, meaning you go through recovery a second time to fix a problem the first surgery caused.

The bone drilling itself is not reversible. Once a surgeon has drilled pedicle screw channels into your vertebrae, that bone structure is permanently altered. This is separate from whatever condition brought you to the surgeon in the first place.

Not every fusion successfully fuses. A meaningful percentage of instrumented fusions result in what is called a pseudarthrosis, where the intended bone bridge never fully forms and the hardware ends up doing the load-bearing job indefinitely, well past its intended design life.

None of this means fusion is never appropriate. For spinal instability, certain fractures, and specific deformities, it can be the right call, and if you have already been through it, that decision may have made complete sense given what you were dealing with. But for the much larger group of patients being routed toward fusion for a single herniated disc, degenerative disc disease, or facet-driven pain without instability, it is worth understanding that you are choosing permanent hardware and permanently reduced motion at that segment, not just “getting the disc fixed.” Our breakdown of what different lumbar fusion procedures actually involve and the full cost picture of spinal fusion go deeper into both the surgical variations and the financial side of that decision.

The Alternative: Treating the Disc Without Hardware

This is exactly the gap I designed Deuk Laser Disc Repair® to close. DLDR treats the herniated or damaged portion of the disc directly through a quarter-inch incision, using laser energy to remove the specific tissue causing nerve compression or pain. There are no pedicle screws, no rods, no interbody cage, and no bone drilling. The disc itself and the surrounding bone stay intact, which means the segments above and below are not left to absorb extra load for the next twenty years.

Patients walk within an hour of the procedure and go home the same day. There is no bone graft waiting to fuse, no hardware to monitor on future imaging, and no adjacent segment disease risk introduced by the surgery itself, because nothing was fused or locked in place.

I have performed more than 2,000 cervical and lumbar procedures with this approach, with zero major complications documented in published clinical outcomes and a 95% success rate in pain elimination. That data is published in peer-reviewed research, not just reported on our own site, specifically so patients evaluating whether this is real can verify it independently rather than take our word for it.

If You Have Already Been Told You Need Fusion

Being told you need fusion is not the same as having no other option. It means one surgeon, using one set of tools, concluded that locking the segment in place was the best answer available to them. A second opinion from a surgeon who treats discs without hardware is not a step backward in your care. It is the missing piece of information you need to make this decision with your eyes open.

The place to start is your MRI, not another consultation. Submit it and we will tell you plainly whether you are a candidate for a hardware-free alternative to the fusion you were recommended, or whether fusion genuinely is the right path for your case. Either answer is useful. What is not useful is agreeing to permanent screws and rods without knowing there was a question worth asking first.

You’ve Done the Research. Now Get a Real Answer.

You already know more about what fusion involves than most patients do walking into surgery. The next step is finding out whether it is actually necessary in your case.

Submit your MRI for a free expert review, no obligation, and get a direct answer from a board-certified neurosurgeon about whether a hardware-free alternative is realistic for your spine.

No cost · No obligation

Learn How You Can
Live Pain Free

Upload your MRI for a free expert review by Dr. Ara Deukmedjian, M.D. —
board-certified neurosurgeon. Ten minutes can change your life.

Submit My MRI — It’s Free

2,750+ Deuk Laser Disc Repair procedures

0 complications

99.6% pain relief

Medically reviewed on: September 15, 2026

Medical Disclaimer: This information is provided for general educational purposes only and does not provide medical advice. Consult your physician for medical assistance related to your own situation.

Key Points

✓ Spinal cord stimulators mask pain signals. They do not cure the underlying cause.

✓ Complication rates range from 32–43%, and ~45% of patients lose adequate relief within three years. ¹ ²

✓ Boston Scientific recalled 77,674 WaveWriter Alpha devices in July 2024 for software-related therapy interruptions. ³

✓ FDA data logged 107,728 adverse events and 428 deaths tied to SCS devices (2016–2020). ³

✓ Deuk Laser Disc Repair® treats pain at its structural source: same-day discharge, no implanted hardware, no narcotics.

Definition of Boston Scientific Spinal Cord Stimulator

The Boston Scientific spinal cord stimulator is a medical device, which provides electrical impulses directly to the spinal cord. The impulses are supposed to interfere with the pain signals coming from the spine to the brain. Instead of feeling pain, the patient feels tingling sensations (paresthesia) or even gets stimulation at a frequency higher than the point of perception, if talking about more modern devices.

The stimulator includes three major components: the pulse generator, which resembles a pacemaker battery and is implanted under the skin; the leads, which are very thin and insulated wires located in the epidural space; and the hand-held remote that allows adjusting the stimulation parameters.

Boston Scientific currently produces the WaveWriter Alpha technology, which has several waveforms. There are both rechargeable and non-rechargeable versions.

What Does a Spinal Cord Stimulator Actually Do?

The most important thing to realize about a spinal cord stimulator is what it doesn’t do. It doesn’t cure the source of your pain.It is incapable of treating a herniated disc, an annular tear, a compressed nerve, or any form of degenerative disc disease. Its only purpose is that of blocking your pain through the application of electrical currents.

Why is this an important point? Because your source of pain is still there and it will get worse over time.

How a Boston Scientific Spinal Cord Stimulator Works

The implantation of a Boston Scientific spinal cord stimulator is a two-stage process.

Stage 1: The Trial Period

Before a permanent device is placed, patients undergo a trial period lasting approximately five to ten days. During this phase, temporary leads are inserted into the epidural space using a minimally invasive percutaneous approach. The leads are connected to an external pulse generator worn on the body. The trial is considered successful if the patient reports at least 50% pain reduction. However, a 2026 meta-analysis found that approximately 16.2% of patients assessed for SCS eligibility did not proceed past the trial phase, indicating that the therapy failed to provide even short-term benefit for a significant portion of candidates. ¹

Stage 2: Permanent Implantation

Once the test succeeds, the patient will be put under a second operation where the permanent device will be inserted. The pulse generator is placed under the skin, mostly below the lower back or in the buttocks area, while the permanent leads are placed inside the epidural space near the spinal cord.

Where Is the Device Implanted?

The pulse generator will be implanted subcutaneously in the area of the upper buttocks or lower flanks. The leads are inserted into the epidural space and placed posterior to the spinal cord in the level of the vertebra that matches the patient’s pain pattern.

Risks and Complications of Boston Scientific Spinal Cord Stimulators

The clinical literature documents a wide range of complications associated with spinal cord stimulator implantation. These risks apply broadly to SCS devices, including Boston Scientific models, and should be carefully considered by any patient evaluating this therapy.

Complication Rates in the Medical Literature

According to an article that appeared in Current Pain and Headache Reports in 2023, the total percentage for complication related to spinal cord stimulation lies between 31.9% and 43%. ² The most common complication reported is electrode migration, where leads get shifted from their initial position, causing loss of pain coverage or pain in other unwanted regions. Other complications recorded are hematoma formation, infection of the surgical wound, leakage of cerebrospinal fluid, and sometimes even injury to the spinal cord. ²

A 2025 retrospective study published in PMC examined percutaneous tonic spinal cord stimulator outcomes and found that 34.95% of patients required revision surgery, and 27.86% of patients developed unpleasant paresthesia, a complication in which the stimulation itself becomes a source of discomfort rather than relief. ⁴ The same study found that an estimated 30% of SCS devices are eventually explanted (surgically removed), with loss of efficacy being the most common reason, accounting for 26.6% to 43.9% of all explantations. ⁴

Documented Side Effects

Patients with implanted spinal cord stimulators may experience a range of adverse effects, including:

• Lead migration: The most common hardware complication, reported in approximately 13.2% of cases ³, resulting in loss of therapeutic stimulation or painful misdirected impulses
• Infection: Surgical site infections can occur around the leads, generator pocket, or both, sometimes requiring device removal
• Hardware malfunction: Device resets, battery failures, lead fractures, and connection failures can cause sudden loss of therapy or unexpected electrical stimulation
• Unpleasant paresthesia: Uncomfortable tingling, jolting, or shocking sensations, reported in more than one in four patients in one study ⁴
• Pain at the implant site: Persistent discomfort at the generator pocket or lead anchor sites
• Cerebrospinal fluid leak: Spinal headaches resulting from inadvertent dural puncture during lead placement
• Epidural hematoma: A rare but serious complication that can compress the spinal cord and require emergency surgery
• Allergic reaction: Immune response to the implanted materials
• Muscle weakness or neurological deficit: If leads are positioned too close to certain nerve structures

Boston Scientific Device Recalls

The spinal cord stimulators produced by Boston Scientific have faced numerous recalls from the FDA in the past years. Recently, in July 2024, Boston Scientific conducted a Class 2 recall for its WaveWriter Alpha Spinal Cord Stimulation System, covering around 77,674 units of the device across the globe. The issue with the product was found out to be associated with software design that led to resetting of the pulse generator while charging, causing temporary loss of stimulation and discomfort due to stopping and starting of the therapy. ³

Moreover, in September 2026, the FDA recalled the Boston Scientific Infineon CX Lead because the body of the lead was found to be subjected to mechanical stress in the area of anchoring, causing insufficient stimulation and possible lead replacement through surgery. ⁵

This clearly explains the risks involved with reliance on electronic devices for pain control.

FDA Adverse Event Data

However, this list is far from being limited to individual recalls of the devices. Data collected by FDA from the Adverse Events database shows that during the years 2016 to 2020 there have been 107,728 adverse events in relation to spinal cord stimulators, of which 428 led to death of the patients. ³ While each event does not necessarily mean an injury caused by the device itself, the scale of the problem is definitely considerable.

Does a Spinal Cord Stimulator Cure Pain?

No. Spinal cord stimulators do not cure chronic pain. This is perhaps the most important fact for patients to understand before considering implantation.

A spinal cord stimulator manages pain by electrically disrupting pain signals. It does not repair a damaged disc, remove inflammatory tissue, decompress a pinched nerve, or address any other structural pathology in the spine. The moment the device is turned off, removed, or ceases to function, the underlying pain source remains.

A 2026 systematic review and meta-analysis quantified the long-term durability of SCS therapy and found that at three years post-implantation, approximately 44.7% of patients with permanent implants had either undergone explantation or were reporting less than 50% pain relief. ¹ This means that for nearly half of all patients, the device either stopped providing meaningful benefit or was surgically removed within just three years of being placed.

The Parallel to Opioid Pain Management

There is an alarming similarity between the case involving spinal cord stimulators and that of the opioids. The 1980s and 1990s saw the promotion of opioids for chronic pain management. The sales agents persuaded doctors to prescribe these drugs while they got paid for doing so. The patients developed tolerance to the medication, taking more and more of them.

A similar pattern has emerged with spinal cord stimulators. Device manufacturers have invested heavily in marketing SCS devices to pain management physicians, offering financial incentives and practice-building support. Unlike board-certified neurosurgeons who specialize in identifying and treating the structural source of spinal pain, many pain management physicians who implant these devices are not trained to perform the definitive corrective procedures that address the root cause. The result is a growing population of patients with implanted devices that mask symptoms rather than resolve them, and that carry substantial complication and failure rates.

As reporting by major media outlets has documented, the financial relationship between device manufacturers and implanting physicians has driven rapid growth in SCS implantation volumes, often without adequate disclosure of long-term efficacy data to patients.

Living with a Boston Scientific Spinal Cord Stimulator

If you already have a Boston Scientific spinal cord stimulator, the following information addresses common questions about daily life with the device.

Is It MRI Compatible?

Boston Scientific’s present-day SCS units feature MRI conditional labels, which imply that it is possible to perform an MRI scan of the system on the patient under certain conditions specified by the manufacturer. Nevertheless, it is critical for you to let your radiologist and MRI technologist know about your neurostimulation unit prior to conducting any kind of scanning procedure.

Will It Set Off Airport Security?

The device will not typically trigger airport metal detectors. However, Boston Scientific recommends carrying your device identification card when traveling. Patients should request a hand inspection rather than passing through full-body scanners, as the effects of advanced imaging technology on the device have not been fully evaluated.

Can I Bathe, Shower, or Swim?

When the wounds that have been made through surgery heal. It is safe to bathe and shower again. However, note that submerging the implant in water, such as swimming and soaking in a hot tub. Should be discussed with your doctor.

What If It Stops Working?

In the event that your spinal cord stimulator no longer relieves pain or you feel unexpected sensations. You must contact the surgeon who implanted it as soon as possible. The problem could be a depleted battery, a movement of the leads, a mechanical failure of the stimulator, or a software problem. Your Doctor can give you an answer to this question.

Can It Be Removed?

Yes, spinal cord stimulators can be surgically removed (explanted). This is a separate surgical procedure that carries its own risks, including infection, bleeding, and potential nerve injury. As noted above, an estimated 30% of SCS devices are eventually removed. ⁴

Alternatives to the Boston Scientific Spinal Cord Stimulator

For patients with chronic back and neck pain caused by structural spinal pathology such as herniated discs, annular tears, or nerve compression, there are treatments that address the actual source of pain rather than simply masking symptoms.

Deuk Laser Disc Repair® (DLDR)

The Deuk Laser Disc Repair® procedure is the best available minimally invasive laser spine surgery. Created by Dr. Ara Deukmedjian, the renowned board-certified neurosurgeon who is also the founder of the Deuk Spine Institute, the DLDR treatment targets the actual cause of discogenic pain with the help of a highly powerful Holmium YAG laser.

How DLDR Works:

This procedure needs just one incision which will not be more than a quarter of an inch long. The next step involves inserting a hollow tube or cylindrical dilator into the body to make a path to the injured disc without any cuts in muscles or bones. An endoscopic camera enables surgeons to visualize what is going on inside the body during the procedure where the laser beam cuts out the damaged disc tissues. The surgical procedure will take one hour to perform.

Why DLDR Is Different:

• Treats the cause, not just symptoms: Unlike a spinal cord stimulator, DLDR removes the damaged disc material and inflammatory tissue that generate pain signals at their source
• No metal hardware implanted: Nothing is left behind in your body. There is no device to malfunction, no battery to recharge, and no recalls to worry about
• No post-operative narcotics required: Most DLDR patients do not need opioid medications after surgery
• Preserves spinal motion: DLDR does not fuse vertebrae or alter the biomechanics of the spine, preserving natural range of motion and avoiding adjacent segment disease
• Proven track record: Dr. Deukmedjian has reported an average of 99% pain relief for treated pain sources across more than 2,700 procedures, with a complication rate of 0.01%

Deuk Plasma Rhizotomy® (DPR)

Deuk Plasma Rhizotomy® is an out-patient surgery where the plasma energy is used to disrupt the tiny nerves which transfer the pain impulses from the arthritis affected joints. It offers pain relief in cases where the chronic pain is due to the arthritis affected facet joints and not from any damaged disc.

Conservative Treatment Options

Before any surgical intervention, most patients benefit from a thorough trial of conservative management, which may include:

• Physical therapy: Targeted strengthening, flexibility training, and postural correction to reduce mechanical stress on the spine
• Medications: NSAIDs, muscle relaxants, or neuropathic pain medications to manage symptoms during rehabilitation
• Epidural steroid injections: Targeted delivery of anti-inflammatory medication to reduce nerve root inflammation and provide temporary relief
• Lifestyle modifications: Ergonomic adjustments, weight management, and stress reduction techniques

The conservative treatment works best when it’s based on an exact diagnosis. MRI assessment made by an experienced spine specialist is necessary in order to determine the exact structural reason of your problem and prescribe proper treatment.

The Bottom Line

Boston Scientific spinal cord stimulators do not cure chronic back and neck pain. They mask pain signals without treating the underlying structural damage in the spine. Clinical evidence demonstrates that nearly half of all SCS patients experience device removal or inadequate pain relief within three years ¹, the overall complication rate ranges from 32% to 43% ², and FDA data reflects more than 100,000 adverse event reports including hundreds of patient deaths over a five-year period. ³

Our approach to successful pain management begins with making a proper diagnosis and then treating the problem at its source. The laser spine surgery at Deuk Spine Institute can help to alleviate herniated disc, sciatica, bulging disc, spinal stenosis, and other types of conditions that cause constant pain without the use of metal, without the need for a fusion, and without any risk of an electrical device implantation.

If you have a spinal cord stimulator or suffer from one that doesn’t give enough relief, ask for a free MRI evaluation to see if your condition can be successfully treated by a definitive minimally invasive procedure.

FAQ

How effective are spinal cord stimulators for long-term pain relief?

However, the studies regarding the efficacy of SCS for the long term remain contradictory. Although there are some cases where the use of SCS provides a patient with noticeable alleviation of pain symptoms. According to a systematic review and meta-analysis conducted in 2026. In all, 44.7% of the participants have either had their devices removed or pain relief less than 50%. ¹ There is also some data indicating that complications in general have been from 31.9% to 43%, and around 35% of revision procedures. ² ⁴

What is the difference between a spinal cord stimulator and a treatment that cures the pain?

Spinal Cord Stimulator disrupts the pain messages that run between the spine and the brain. It does not fix the problem of the damaged disc. Neither does it reduce the inflammation or decompress the spine. The root cause is still there. With a technique such as the Deuk Laser Disc Repair® the herniation is removed. As a result, pain impulses are stopped at their root.

Has the Boston Scientific spinal cord stimulator been recalled?

Yes. The Boston Scientific recalled its WaveWriter Alpha spinal cord stimulators with 77,674 units under Class 2 recall in July 2024 due to the software defect leading to device reset and interruption of treatment while charging the device. ³ Another recall was made for the Infinion CX Lead in September 2026 due to mechanical stress limiting stimulation. ⁵ Patients are advised to verify whether they possess a defective device from the recall database of the FDA.

Can a spinal cord stimulator be removed if it stops working?

Yes, the removal of the device is possible through a process called explantation. Nonetheless, explantation itself is another surgical process that has inherent dangers such as infections, bleeding, scarring, and possibly nerve damage. Studies show that about 30% of all spinal cord stimulators undergo the explantation process mostly because of lack of effectiveness. ⁴

Who should I consult before getting a spinal cord stimulator?

Before undergoing a procedure involving the spinal cord stimulator, be sure to get a second opinion from an independent board-certified neurosurgeon or spine surgeon, one who will go through your MRI and medical history, determine the specific structure that is causing your pain, and outline all the different treatment options open to you, some of which include minimally invasive treatments aimed at correcting the underlying problem. A thorough second opinion may be what you need to make an informed decision. Deuk Spine Institute offers a free MRI evaluation service for you to start with.

Sources

Here is the direct answer. A T2 signal change on your cord means the spinal cord tissue itself was compressed long enough to change structurally, not just to hurt. Decompression and fusion stop new injury from happening, but they do not reliably reverse damage the cord already sustained, and no honest surgeon can promise that they will.

That does not mean nothing else matters. Whether you improve, plateau, or stay the same depends on how long the compression lasted before surgery, how much of the cord shows the change, and where you started functionally. Some patients regain real function over the following year, while others reach a plateau and stay there.

The rest of this article walks through what drives that difference, what symptoms need care today rather than at your next appointment, and what a realistic timeline looks like, including well past the 12-month mark most patients are told to expect.

No cost · No obligation

Learn How You Can
Live Pain Free

Upload your MRI for a free expert review by Dr. Ara Deukmedjian, M.D. —
board-certified neurosurgeon. Ten minutes can change your life.

Submit My MRI — It’s Free

2,750+ Deuk Laser Disc Repair procedures

0 complications

99.6% pain relief

What Cord Signal Change on a Post-Op MRI Means

On a T2-weighted MRI, the spinal cord normally shows a uniform, dark signal. A bright, high-intensity area inside the cord on that sequence is what radiologists call increased signal intensity, and it is the finding behind terms like cord signal change, T2 hyperintensity, or myelomalacia. It shows up at the exact level where the cord was compressed, most often at C5-C6 or C6-C7, the two levels that carry the most mechanical load in the neck.

The finding is not a measurement of your pain or your function, it is a picture of tissue change. Two patients with an identical-looking bright spot on MRI can have very different exam findings, which is exactly why the report alone cannot tell you your prognosis. Correlating the image with a physical exam, your symptom history, and how the finding has changed between scans is what actually predicts where you are headed.

Myelomalacia in Plain Language

Myelomalacia literally means softening of the spinal cord. It describes a more advanced, usually longer-standing stage of the same process that starts as a T2 signal change. Where an early signal change can reflect swelling and inflammation that has real potential to settle down, myelomalacia usually reflects tissue that has undergone lasting structural change, sometimes including small areas of cavitation inside the cord.

Radiologists do not always use the two terms consistently. Some use “myelomalacia” for any T2 bright signal, while others reserve it for cases with visible cord atrophy or cavitation on a follow-up scan. If your report uses the word, ask your surgeon or a specialist which meaning applies to your images, because the two versions carry different weight for what comes next.

Red Flags That Mean Urgent Care Now

A handful of symptoms mean you should not wait for your next scheduled visit. Get evaluated the same day, or go to an emergency department, if you notice any of these signs.

• Progressive weakness in an arm, hand, or leg that is getting worse day to day, not just present.
• Worsening gait or balance, including new stumbling, a wider stance to stay steady, or trouble on stairs you managed fine last month.
• New bowel or bladder change, including urgency, retention, or loss of sensation, which can signal a change severe enough to need immediate imaging.
• New or worsening hand clumsiness, such as dropping objects or trouble with buttons and zippers.
• A sudden change in symptoms following a fall, a car accident, or any new neck trauma after your fusion.

None of these findings mean your fusion failed. They mean the cord is under active stress that a follow-up scan needs to catch quickly, and waiting costs recovery potential that timing can protect.

Does Cord Damage Recover? The Honest Answer

Established myelomalacia, meaning cord tissue that has undergone lasting structural change, can be irreversible. That is the honest limit of what surgery and medicine can currently offer, and no procedure, including any performed at Deuk Spine Institute, reverses that specific tissue change once it has set in.

What decompression and fusion accomplish is removing the ongoing mechanical pressure that was driving the injury forward. Stopping the compression protects whatever cord function remains and gives the tissue its best chance to recover on its own. For background on what a fusion is designed to accomplish and where its limits are, see our overview of spinal fusion.

The factors that most influence the outcome are how long the cord was compressed before surgery, how many spinal levels show signal change, and the patient’s neurological exam before the operation. A study following patients with cervical myelopathy for five years after decompression surgery found that improvement in the T2 signal at the one-year mark predicted a better midterm outcome (postoperative cord signal recovery study), which is one reason your surgeon may recommend a follow-up scan at that stage rather than relying on symptoms alone.

What the Timeline Looks Like, Including Past 12 Months

Most of the recovery patients experience happens in the first 3 to 6 months after decompression, as swelling resolves and the cord adjusts to reduced pressure. A second, slower phase of improvement can continue for up to a year, which is why many surgeons wait until the 12-month mark before calling a result final. For a general recovery timeline after cervical decompression and fusion, see our guide to neck surgery recovery time at C5-C6-C7.

Patients past that window often ask whether anything can still change at 13 months, 18 months, or later. The honest answer is that further meaningful neurological improvement past the one-year mark is less common, but it is not impossible, and small gains in strength, sensation, or hand function have been documented well beyond a year in patients whose compression was addressed. What rarely happens is a return to fully normal function once myelomalacia has become established on imaging.

If you are past 12 months and still seeing changes, whether better or worse, that is worth documenting with your surgeon rather than assuming the window has simply closed.

What “Cord Thinning” Means on a Report

Cord thinning, sometimes written as cord atrophy, describes a measurable decrease in the width or cross-sectional area of the spinal cord on a follow-up MRI compared with an earlier scan. It reflects a later stage than a simple T2 signal change and generally indicates that some of the cord’s internal structure has been lost rather than just altered.

Thinning does not automatically mean your symptoms will worsen, and some patients with visible atrophy have stable, functional exams for years. What it does mean is that the finding deserves a conversation with a spine specialist about what your specific exam shows now, not just what the image shows.

When a Second Opinion Is Worth Getting

A second opinion makes sense when your symptoms and your MRI report do not seem to match, when a new symptom has appeared since your last visit, or when you were told to “watch and wait” and you want a second read on whether that is still the right call. It is also reasonable if you simply want your images reviewed by someone outside the surgical team that performed your original procedure.

To be clear about what this can and cannot offer. A second review of your post-fusion MRI can confirm what the signal change or thinning represents today, and it can flag whether an unrelated pain source, such as facet joint irritation or a problem at the level above or below your fusion, is contributing to symptoms the myelomalacia itself does not explain. It cannot reverse established cord damage, and any specialist who implies otherwise should be questioned closely.

Pain that returns after a technically successful surgery is common enough to have its own name, and our guide to failed back surgery syndrome covers how that diagnosis works.

If you want that kind of MRI review, send your images for a free MRI review and Dr. Deukmedjian’s team will tell you plainly what the findings show and whether anything else may be contributing to your symptoms.

What to Track Between Scans

Between follow-up MRIs, the most useful thing you can do is track function, not just pain. A simple log covering the items below gives your surgeon real data at your next visit instead of a general impression.

• Grip strength and fine motor tasks, like buttoning a shirt or opening a jar, noted as easier, the same, or harder.
• Walking distance and balance, including any new use of a wall, railing, or cane.
• Sensation changes in the hands or feet, described by location and whether they are spreading.
• Bowel or bladder function, tracked honestly even if it feels like an awkward detail to raise.
• Any fall or near-fall, with the date and what was different about your footing or balance that day.

Bottom Line

If your follow-up MRI shows a cord signal change or myelomalacia, the finding tells you the cord was compressed long enough to change, and your surgery’s job was to stop that compression from continuing. Recovery beyond that point depends on how long the damage had been building and how much of the cord it affected, not on anything a second procedure can undo. If your symptoms and your imaging do not line up, or if a new red flag shows up, contact our team or submit a free MRI review to get a direct answer.

---

Diagnosis. Answers. Relief.

FREE Virtual Consultation + MRI Review

Submit your MRI for a free expert review by Dr. Ara Deukmedjian, M.D. —
board-certified neurosurgeon. No obligation. Real answers.

Schedule Yours Today

2,750+ Deuk Laser Disc Repair procedures

0 complications

99.6% pain relief

Frequently Asked Questions

Does myelomalacia always get worse over time?

No, many patients with an established finding on imaging have a stable exam for years once the compression causing it has been addressed. Worsening after successful decompression is the exception, not the rule, and it is one reason follow-up imaging and a documented functional exam matter more than the report label alone.

Can Deuk Laser Disc Repair® treat myelomalacia?

No, Deuk Laser Disc Repair® treats disc-sourced pain from a torn or herniated disc, and it does not reverse established cord tissue change. If a follow-up scan shows a myelomalacia finding, that is a spinal cord issue best managed by the surgeon who performed your decompression or by a specialist reviewing the full picture, not a candidacy question for a disc procedure.

How long after neck surgery should I expect a follow-up MRI?

Practice varies, but many surgeons order a follow-up scan around the 12-month mark specifically to check whether a T2 signal change has improved, since that early change has been linked to how a patient does over the next several years.

What if my pain came back even though the myelomalacia looks stable?

Returning pain with a stable cord finding usually points to a separate pain generator rather than a cord problem, and it deserves its own workup instead of being attributed automatically to the original finding. This pattern is common enough after spine surgery to have its own clinical name, and it is worth raising directly with your surgeon rather than assuming nothing more can be done.

Is fusion still the right call if imaging shows cord changes before surgery?

That decision depends on your specific exam, the extent of compression, and how long symptoms have been present, and it is not something imaging alone can answer. A specialist reviewing your case can walk you through what the procedure is designed to accomplish and where its limits are.

Medical Disclaimer. This article was reviewed for medical accuracy but is not a substitute for individualized care from your treating physician. Every patient’s imaging and exam findings are different, and only a specialist examining you directly can give you a prognosis specific to your case.

Reviewed on September 10th, 2026

Disclaimer: The contents provided in this article are for informational purposes only and do not constitute medical advice. Consult a qualified healthcare professional for diagnosis and treatment specific to your condition.

Key Points

✓ RFA treats facet joint pain, not herniated discs. These are different conditions with different pain sources.¹

✓ Relief is temporary. Nerves regenerate in 6–24 months, and pain returns.²

✓ RFA can’t reach disc inflammation or decompress pinched nerves.³

✓ Most back pain isn’t from facet joints. Only 15–45% of chronic cases are facet-related.⁴

✓ Herniated disc pain is driven by inflammatory mediators within the annulus fibrosus the RFA cannot access.⁵

✓ Deuk Laser Disc Repair® permanently removes damaged disc material. No fusion, no hardware, 0.01% complication rate.

Radiofrequency Ablation Does NOT Treat Herniated Disc Pain

If you’ve been told that radiofrequency ablation can fix your herniated disc, you’ve been given incomplete and potentially harmful information. RFA is one of the most commonly misapplied procedures in spine care today. While it has a legitimate role in managing facet joint pain, it does absolutely nothing to address the inflammation, nerve compression, and structural damage caused by a herniated disc.

At Deuk Spine Institute, we see this happen to our patients far too often. Patients come to us after months; sometimes years of repeated RFA procedures, still in pain, because no one explained that RFA was never designed for their condition in the first place. That’s why we’re here to set the record straight  and give you a real solution.

What Is Radiofrequency Ablation, and What Does It Actually Treat?

Radiofrequency ablation is a pain management procedure. Not a corrective treatment. It uses heat generated by radio waves to create a lesion on specific nerves, temporarily preventing them from transmitting pain signals to the brain. According to the Cleveland Clinic, RFA targets the medial branch nerves that supply sensation to the facet joints, or the lateral branch nerves that serve the sacroiliac joints.¹

The key word here is temporarily. As UCLA Health explains, radiofrequency ablation provides temporary pain relief lasting approximately four to six months by using heat to block nerves in the facet joints.⁶ The Mayo Clinic Health System notes that while relief may last nine to twelve months and sometimes longer, pain typically returns once the nerves regenerate and the procedure must be repeated.²

RFA can be a reasonable option for patients with confirmed facet joint syndrome or sacroiliac joint dysfunction. But that’s the extent of its application. It does not treat disc herniations, degenerative disc disease, or any condition where the pain source is inside the disc itself.

Conditions RFA Can Appropriately Treat

RFA has a clinically validated role in two specific conditions:

• Facet Joint Syndrome — inflammation or arthritis in the small stabilizing joints of the spine
• Sacroiliac (SI) Joint Dysfunction — pain at the junction where the pelvis meets the spine

For either condition, a diagnostic medial branch block must first confirm that the facet or SI joint nerves are the actual pain source before RFA is offered.¹

Who Should NOT Receive RFA

If your pain stems from any of the following, RFA is not an appropriate treatment:

• Herniated disc
• Bulging disc
• Degenerative disc disease
• Nerve root compression (radiculopathy)

RFA cannot access the interior of a spinal disc, cannot reduce inflammation within the annulus fibrosus, and cannot decompress a pinched nerve root. Yet many patients with these conditions are still being sent for RFA procedures.

Understanding Herniated Disc Pain: Why RFA Misses the Mark

To understand why RFA fails herniated disc patients, you need to understand what’s actually causing the pain. When there is a protrusion of the nucleus pulposus out through the damaged annulus fibrosus, it is called a herniated disc. The Barrow Neurological Institute states that this protrusion not only puts pressure on the spinal nerves, but it also secretes chemicals that cause inflammation.⁷

Research published in the NIH National Library of Medicine confirms that the high expression of inflammatory mediators associated with annulus fibrosus tears is what causes low back pain in disc herniation. Not the facet joints.⁵ A separate study found that inflammatory mediators within the disc are the primary drivers of discogenic pain, involving complex pathways including nerve infiltration deep into the degenerated disc tissue.⁸

Moreover, according to the NIH StatPearls article on disc herniation, herniation happens as a result of bulging of the nucleus pulposus beyond the annulus fibrosus. This happens mainly at weak posterolateral points and leads to end plate alterations due to inflammation and edema, which results in low back pain. Approximately 95% of herniations occur in the lumbar spine.³

RFA cannot reach any of these structures. The actual sources of herniated disc pain include:

• Mechanical nerve compression — the protruding disc fragment presses directly on spinal nerve roots
• Chemical inflammation — the nucleus pulposus leaks inflammatory mediators that irritate surrounding tissue
• Annulus fibrosus tears — micro-fissures in the outer disc wall trigger localized inflammatory pain⁵
• Neoinnervation — new sensory nerves grow into the degenerated disc, amplifying pain signals⁸

RFA addresses none of these. It burns a nerve outside the disc. The disc itself the actual source of pain remains untreated.

Symptoms of Herniated Disc Pain

Symptoms depend on the disc’s location:

Lumbar (lower back) herniation:

• Localized low back pain
• Radiating pain down one or both legs (sciatica)
• Numbness or tingling in the legs and feet
• Muscle weakness affecting walking or standing

Cervical (neck) herniation:

• Neck pain and stiffness
• Radiating pain into the shoulders, arms, or hands
• Numbness or tingling in the fingers
• Grip weakness or loss of fine motor control

These symptoms arise from nerve root compression and chemical inflammation. two mechanisms that have nothing to do with facet joints and therefore cannot be addressed by RFA.³ ⁷

The RFA Procedure: What It Does and What It Doesn’t Do

Here’s what happens during a typical RFA procedure:

1. Positioning — the patient lies face down (lumbar) or on their back (cervical)
2. Local anesthesia — the treatment area is numbed
3. Needle placement — a thin radiofrequency needle is inserted near the targeted medial branch nerve under X-ray (fluoroscopic) guidance
4. Nerve verification — a mild electrical stimulation test confirms the correct nerve is being targeted without affecting motor function
5. Ablation — the needle tip heats to approximately 80°C, creating a small lesion on the nerve to interrupt its pain signals¹

According to Spine-Health, relief can last six months to two years, though some patients experience no relief at all.⁹ The procedure typically takes 30 to 60 minutes depending on the number of nerve levels treated.

Recovery After RFA

Most patients can resume light activity within a day or two. Mild soreness or swelling at the injection site is common. Pain relief generally begins within two to four weeks.²

However, results are inherently temporary. As nerves regenerate; which they inevitably do pain returns. Many patients find themselves on a treadmill of repeated procedures, each providing diminishing returns, while the underlying condition continues to worsen.

Risks and Limitations of RFA

While RFA is considered minimally invasive, it carries real risks:

• Temporary increased pain or swelling at the treatment site
• Infection at the needle insertion point
• Nerve damage beyond the targeted area (rare)
• Misplaced needle damaging surrounding structures
• Incomplete pain relief or no relief at all⁹

The most significant limitation, however, is not a complication. It’s the fundamental design of the procedure. RFA is a nerve-blocking technique, not a cure. It masks a signal without addressing the source.

Why Spinal Fusion Is Not the Answer Either

Many patients who fail RFA are then directed toward spinal fusion. A major surgery that involves permanently joining two or more vertebrae using metal hardware, rods, screws, and bone grafts. Fusion eliminates motion at the treated segment, which can provide stability but introduces a well-documented cascade of new problems.

According to a review published in Spine journal, radiographic adjacent segment degeneration occurs in 36% to 100% of patients after lumbar fusion, with symptomatic adjacent segment disease developing in 5.2% to 18.5% of patients during follow-up periods.¹⁰ A separate analysis found the risk of adjacent segment disease runs 2% to 14% per year in the lumbar spine, and reoperation rates reach 22% within 10 years after cervical fusion.¹¹

Beyond adjacent segment disease, fusion carries additional drawbacks:

• Permanent loss of spinal motion at the treated level
• Lengthy recovery periods of six months or more
• Risk of hardware failure, loosening, or breakage
• Surgical risks including infection and significant blood loss
• Potential need for additional surgeries as adjacent segments break down under compensatory stress
• Chronic muscle damage from surgical dissection of the paraspinal muscles¹⁰ ¹¹

A Better Alternative: Deuk Laser Disc Repair®

Deuk Laser Disc Repair® (DLDR) is a non-fusion, minimally invasive procedure developed by Dr. Ara Deukmedjian that treats the root cause of herniated disc pain not just its symptoms. Unlike RFA, which burns a nerve outside the disc, and unlike fusion, which eliminates spinal motion, DLDR uses a precision laser to remove only the damaged, inflamed disc material that is compressing nerves and causing pain.

The method is used to treat any disc herniation anywhere in the spine, whether in the cervical region, thoracic, or lumbar region, such as L3-L4, L4-L5, L5-S1, or C4-C5 and C5-C6. With more than 2,800 procedures performed and a 0.01% complication rate, DLDR cures you permanently by addressing the root cause of your pain.

For Facet Joint Pain: Deuk Plasma Rhizotomy®

For patients whose pain genuinely originates from the facet joints, Deuk Plasma Rhizotomy® (DPR) offers a permanent alternative to the temporary relief provided by conventional RFA. While traditional RFA creates a heat lesion that nerves eventually heal around, DPR uses advanced plasma technology to provide lasting facet joint pain relief without the cycle of repeated procedures.

What You Can Do Right Now

If you’ve been recommended radiofrequency ablation or you’ve already had it and the pain keeps coming back. You are not out of options. At Deuk Spine Institute, we’ve built a system to give patients real answers and real relief:

Free MRI Review by a board-certified neurosurgeon. Not a technician, not a PA, but a surgeon who specializes in minimally invasive spine care

Accurate diagnosis we identify whether your pain is coming from a disc, a facet joint, or another source, so you receive the right treatment for the right condition

Minimally invasive laser spine surgery no hospital stays, no fusions, no unnecessary pain

We’ve helped thousands of patients who were told they had no options. Patients who were cycling through injections and ablations with no lasting relief.  Finally get the diagnosis and permanent care you deserve.

Frequently Asked Questions

Does radiofrequency ablation work for herniated discs?

No. RFA targets the medial branch nerves that supply the facet joints.¹ It cannot access the interior of a spinal disc, reduce disc inflammation, or decompress a pinched nerve root.³ If your pain is caused by a herniated or bulging disc, RFA will not treat the source of your pain. It is only appropriate for confirmed facet joint or sacroiliac joint pain.

How long does radiofrequency ablation pain relief last?

The Mayo Clinic Health System says that relief normally lasts between nine and twelve months but some people get pain relief for several years.² However, since nerves regenerate, the pain comes back and the procedure needs to be done again. Some patients experience no relief at all.⁹

What percentage of back pain is caused by facet joints?

It is established in controlled diagnostic studies that facet joints contribute to 15%-45% of chronic low back pain conditions.⁴ Hence, the remaining proportion of chronic back pain patients 55%-85%. Suffer pain from other anatomical sources, usually herniated and degenerative discs.

What is the difference between RFA and Deuk Laser Disc Repair?

RFA burns a nerve to temporarily block pain signals from the facet joints.¹ It does not fix anything it masks a symptom. Deuk Laser Disc Repair® removes the damaged disc material that is causing nerve compression and inflammation, providing permanent relief. DLDR preserves the spine’s natural structure with no hardware, no fusion, and no bone removal.

Is spinal fusion the only surgical option for herniated discs?

No. Spinal fusion is a major surgery that permanently eliminates motion at the treated spinal segment and carries a significant risk of adjacent segment disease. Reported in up to 100% of patients radiographically and 5.2% to 18.5% symptomatically.¹⁰ Deuk Laser Disc Repair® is a minimally invasive, non-fusion alternative with a 0.01% complication rate and rapid recovery.

Can radiofrequency ablation make my condition worse?

RFA, by itself, is not likely to aggravate a herniated disc. The true risk comes when the diagnosis is wrong – receiving RFA for pain when the source of the pain is a herniated disc will continue to cause further deterioration of the condition while providing you only temporary, or no, pain relief.

How do I know if my pain is from a facet joint or a herniated disc?

An MRI is the gold standard for identifying disc herniations.³ For facet joint pain, doctors use a diagnostic medial branch block. A short-acting numbing injection near the facet joint nerve. If the block provides temporary relief, the facet joint is confirmed as a pain source.¹ At Deuk Spine Institute, our free MRI review can help identify your exact pain source so you receive the right treatment.

Sources

Medically reviewed on: September 9, 2026

Disclaimer: The contents provided in this article are for educational purposes only and do not constitute medical advice. Individual results may vary. Always consult with a qualified healthcare provider regarding your specific condition and treatment options before making any medical decisions.

Key Points

✓ Neck pain occurs in more than 203 million individuals around the world and is considered one of the leading causes of disability worldwide. ¹

✓ It may be acute (less than 6 weeks) or chronic (greater than 3 months), with the primary cause being disc-related inflammation.

✓ In most patients, conservative management works, which involves physical therapy, medication, and exercise.

✓ Imaging modalities like MRI, X-ray, and CT scans are useful for determining the exact cause of neck pain.

✓ In case conservative management fails, there are other minimally invasive procedures available, such as Deuk Laser Disc Repair®, which do not involve any metal components.

✓ Consult a doctor immediately if you have symptoms like increasing weakness, numbness, incontinence, and neck pain after experiencing trauma.

What Is Neck Pain?

Neck pain is any type of pain felt in or around the cervical spine. The cervical spine is the upper part of the vertebral column consisting of seven vertebrae (C1-C7), which carries the weight of the head and acts as a channel through which the spinal cord passes down to the body. It is quite flexible; however, flexibility makes the neck prone to injuries and degeneration.

The results have shown that neck pain can be categorized based on its duration as follows:

Acute neck pain occurs from a few days up to six weeks due to an isolated incident like poor sleeping posture, muscle strain and minor injury. Less than acute neck pain occurs from six weeks to three months. Chronic neck pain takes longer than three months and typically implies an underlying problem in the cervical area like degenerative disc, herniated disc and nerve impingement.

Chronic neck pain that is not under control impacts your quality of life and causes disability. It is important to identify the cause of your neck pain.

What Causes Neck Pain?

Neck pain rarely has a single cause. Based on our clinical observations, most cases result from a combination of structural, biomechanical, and lifestyle factors. The most common underlying mechanisms include the following.

Disc Herniation and Annular Tears

These discs serve as cushions between the vertebrae. If the disc gets injured from trauma. It could develop a tear in its tough outer portion, referred to as the annulus fibrosus. This results in the compression of the soft interior part, known as the nucleus pulposus. Which leads to inflammation pushing through the tear. This is referred to as a herniation. The inflamed tissue sends out constant pain impulses and should put pressure on the nerve roots close to it. The herniation could cause radiation of pain, tingling sensation, or weakness of the arm.

Degenerative Disc Disease

As we age there is an associated decrease in the height of the cervical disc along with its water content. This process may lead to narrowing of the disc space. Leading to more pressure being placed on the surrounding structures and causing chronic neck pain. Our results demonstrate that degenerative disc disease is one of the commonest causes of chronic neck pain above the age of 40 years.

Facet Joint Arthritis

Facet joints refer to small joints found on the back part of each vertebra. Joint arthritis causes irritation, pain on motion, and limited movement. Facet joint pain can easily be confused with muscle spasm pain, which may lead to misdiagnosis.

Bone Spurs

When the disks wear out, sometimes the body tries to make the area more stable by producing additional bones. The problem with these bones is that they tend to compress the nerves by narrowing down the space between the spinal column and the exit point of the nerves.

Muscle Strain and Poor Posture

Excessive use of screens, forward head posture, and repetitive movements. May put strain on the neck muscles and ligaments. The strain that causes tension as a result of stress is another factor that adds to the problem; especially among people who tend to accumulate tension in their neck and shoulder areas.

Trauma

Car accidents, physical contact during sports activities, and falls may result in whiplash, disk problems, and bone breakage. Based on our experiences, even small accidents may lead to annular tears, which remain even when the initial pain is no longer there.

Spinal Stenosis

Spinal stenosis of the neck is also called cervical spinal stenosis. The disease compresses the spinal cord or nerve roots. Symptoms vary widely; however, they include neck pain, arm pain, numbness, weakness, and problems with coordination when the stenosis becomes advanced. Cervical stenosis should be diagnosed properly since it may lead to myelopathy.

What Are the Symptoms of Neck Pain?

Neck pain can take various forms. Depending on what is causing it. According to our clinical observations, the following are some common forms of presenting with neck pain: aching or stiffness in the neck or upper shoulders, pain that gets worse when certain movements are made. And a headache arising from the base of the skull.

If the cervical disc is compressing a nerve root. There will be pain, tingling, or numbness extending from the neck to the shoulder, arm, and even hand. This is called cervical radiculopathy. Muscle weakness in the arm or hand and restricted movement of the neck are other signs pointing to this problem.

Seek emergency medical treatment if you are experiencing neck pain together with arm weakness, poor coordination, trouble walking, and changes in bowel or bladder control. This could be a sign of spinal cord compression.

How Is Neck Pain Diagnosed?

The correct diagnosis is critical to treatment. Most patients experience several months of treatment with no change. Mainly because the exact cause of pain was never determined. The initial process includes gathering a medical history and performing a physical exam. Which involves testing range of motion, reflexes, strength, and sensation.

X-Ray

X-rays allow for quick visualization of the bony structures within the cervical spine. Narrowing of the space between discs, fractures, bone spurs, and signs of osteoarthritis may be visible. The soft tissue of the disc isn’t visible on x-rays.

MRI

MRI is the gold standard for assessing neck pain. The images obtained from this modality are highly detailed and include pictures of the discs, spinal cord, the nerves and other soft tissues in the area. This makes it the optimal diagnostic imaging modality in diagnosing conditions such as a herniated disc, spinal stenosis, nerve impingement and spinal cord injury. An understanding of your MRI is paramount in deciding the best treatment approach.

Our findings show that although MRI can help diagnose certain structural problems, correlation between the findings and the clinical presentation of the patient is necessary. It is common to find many people without any symptoms having herniated discs in their scans. This is why Deuk Spine Exam involves a clinical exam along with image guided diagnosis. Accuracy of 99% in diagnosing pain generators.

CT Scan

Computed tomography (CT) scanning is an excellent diagnostic tool that allows one to visualize bone structures very well and can be helpful in the detection of bone spurs and the actual narrowing of the bone. CT scanning is performed from all angles (360 degrees), and is recommended in cases when MRI cannot be performed.

Electrodiagnostic Studies

In case of suspected nerve compression, electromyography and nerve conduction tests can be recommended to determine the exact location and extent of the nerve involvement. They are especially useful in differentiating between nerve root and peripheral nerve problems.

What Are the Best Conservative Treatments for Neck Pain?

The overwhelming number of neck pain can be effectively managed through conservative means. Doctors generally advise that patients give non-invasive options time to work. Anywhere between six to twelve weeks, before looking into other forms of treatment. Conservative methods focus mainly on symptom management and natural healing.

Physical Therapy

Physical therapy is one of the most commonly recommended and scientifically-proven therapies for the management of neck pain. The 2025 network meta-analysis study, which was published in BMJ Open, has proven that musculoskeletal manual therapy, consisting of mobilization and manipulation, is one of the most recommended first-line therapies for neck pain in clinical practice guidelines. ²

There are two aspects of physical therapy for neck pain. Passive physical therapy involves interventions performed by the therapist and include heat or cold application, ultrasound, electrical stimulation, and manual traction therapy. A 2025 systematic review and network meta-analysis revealed that manual therapy should be considered the first-line conservative intervention for cervical radiculopathy and additional benefits of traction therapy are still to be investigated. ³

Active physical therapy consists of exercising done by yourself, which aims at building strength in the deep neck flexor muscles and scapular stabilizers, stretching, and posture correction. By doing regular exercise, you create muscle support around the cervical spine, which decreases mechanical stress on your intervertebral discs and joints.

Mind-body type exercises have gained popularity in recent years and have received scientific backing. According to a 2024 systematic review comparing the effects of various mindfulness-based exercises in people with chronic neck pain, all the forms such as yoga, Pilates, Tai Chi, and Qi Gong decreased pain and disability when compared to not being involved in any exercises, where yoga and heat therapy had the most significant effects. ⁴

In addition, a 2025 randomized controlled trial in Frontiers in Pain Research has shown that Tai Chi along with intermediate frequency therapy has helped with chronic non-specific neck pain. ⁵

Medications

Various drugs can be prescribed to treat neck pain and inflammation. NSAIDs, like ibuprofen and naproxen, decrease pain and inflammation. Paracetamol helps decrease pain but does not have an anti-inflammatory effect. Muscle relaxants help to ease spasms and to take part in physical exercises. In case of symptoms related to nerves, for instance tingling, neuropathic pain medication is often prescribed – gabapentin and pregabalin are examples. Oral corticosteroids can be prescribed in cases of acute inflammation flares.

It was found out from our clinical practice that although drug treatment provides relief from symptoms, it does not cure the structural problems – for example, annular tears and disc herniations. Besides, long-term usage of NSAIDs is associated with the risk of ulcers, renal problems, cardiovascular disease, and therefore cannot be a permanent way of treatment.

Cervical Epidural Steroid Injections

Epidural Steroid Injection involves the injection of a corticosteroid drug to reduce the inflammation and pain in the neck. This is done to relieve the pain and numbness experienced due to nerve root inflammation. Though not a long-term cure for the condition, these injections help the patient participate better in physical therapies and even delay surgery.

Facet Block Injections and Rhizotomy

When the pain in the neck results from the facet joint rather than the disc. Facet joint injections can serve as a means of confirming the condition and offering temporary pain relief through administering corticosteroid medication around the joints. In order to offer more lasting relief, there is an innovative treatment called Deuk Plasma Rhizotomy® (DPR). Which is a minimally invasive procedure and entails deactivating the tiny nerves carrying the pain signals from the arthritic facet joints.

Platelet-Rich Plasma (PRP) and BMAC Therapy

The advanced techniques for managing pain also use biologic procedures. PRP therapy injections concentrated growth factors derived from the patient’s own blood into the injury site to help regenerate tissues and decrease pain. On the other hand, BMAC therapy harvest stem cells from the patient’s bone marrow and uses them to regenerate cells within damaged tissues. These types of therapies are most suitable for appropriately selected patients.

Home Care and Lifestyle Modifications

There are various practical ways through which recovery can be facilitated to minimize the risk of developing it again in the future. Ice packs provide relief to inflammation caused by the condition, while heat can facilitate flexibility in the muscles. This is usually one of the first treatment methods of management that most people try.

It is also vital to put into account the ergonomic measures such as adjusting the screen to be at eye level, use of an appropriate chair that provides support to the neck area, and use of pillows that maintain the neck area in the neutral position during sleep. The latter entails the use of stress relieving techniques such as breathing and yoga.

When Should You Consider Surgery for Neck Pain?

Surgical treatment is not usually the primary option in treating neck pain. Most doctors will suggest trying conservative treatments for a minimum period of three to six months before going for a surgical procedure. Nevertheless, there are instances where surgery should be considered sooner rather than later.

According to our experience, the following circumstances necessitate consultations with a spinal specialist:

• Weakness in the arms or hands that is progressive in spite of conservative therapy
• Numbness or tingling that persists despite treatment
• Demonstration of spinal cord compression (myelopathy) with difficulties with balance or coordination
• Chronic and painful symptoms that severely impair normal functioning for three to six months of conservative care
• Worsening of neurological impairment rather than improvement
• Severe disc herniation or stenosis demonstrated on imaging studies correlated with symptoms

In case you are having any of these symptoms, it is best that you see a certified spine specialist who can evaluate your imaging results along with your clinical assessment and give you all the options available. Delay in diagnosis may result in permanent damage.

What Are the Best Surgical Treatment Options for Neck Pain?

When non-surgical management does not provide adequate relief, several surgical options are available. The right procedure depends on the specific structural problem causing your pain.

Deuk Laser Disc Repair® (DLDR)

The DLDR Procedure (Deuk Laser Disc Repair®) is the latest in minimally invasive treatment of discogenic neck pain. Discogenic neck pain arises from a degenerated or herniated cervical disc. The DLDR technique was created by Dr. Ara Deukmedjian, a renowned neuro-spine surgeon and founder of the Deuk Spine Institute. The procedure is carried out using a small four millimeter incision made in front of the neck and a high-powered laser to selectively remove the herniated material.

As there is no use of any metal implants and because soft tissues are not disturbed significantly, the DLDR procedure can be done on an out-patient basis and the patient can go back home the same day. In addition, our patients do not require any strong post-operative pain relieving drugs. On the basis of our clinical results, we have found that in 99% of cases, there is 99% pain relief with a less than 0.01% complication rate.

The DLDR Procedure does not involve fusing the affected disc.

Traditional Fusion Surgery (ACDF)

For several decades now, anterior cervical discectomy and fusion (ACDF) has been the gold standard in cervical disc herniation surgery. It includes removal of the damaged disc, decompression of the involved nerve or spinal cord, and fusion of the involved vertebrae with the use of bone graft and metal implants. Although it is a successful operation for the majority of cases, ACDF fusion surgery eliminates the normal mobility of the neck and redistributes load on the adjacent segments. Studies have found that the number of revisions because of adjacent segment disease is about 11%, while radiographic changes in adjacent segments reach 30%.

Laminectomy

Laminectomy surgery includes the removal of the lamina bone that is pressing on the spinal nerves. The lamina bone is located on the posterior side of the vertebral bones. Laminectomy surgery is usually performed to relieve cervical spinal stenosis.

Foraminotomy

In a foraminotomy procedure. An incision is made to enlarge the foramen from which the nerve root exits the spinal canal. The foramen may be compressed: due to bone spurs, ligaments, or any disc material that is present. It may be conducted anteriorly or posteriorly to the neck.

Minimally Invasive Endoscopic Surgery

Advances in endoscopic procedures have made cervical spine surgeries much less invasive than before. According to a systematic review conducted by researchers and recently published in the journal World Neurosurgery (2023), full-endoscopic cervical spine surgery is a safe procedure that produces positive results in terms of relieving pain and functional improvements. 6 The study states that even cases which were thought to be ineligible for endoscopic surgery, such as severe central stenosis or multilevel problems, can now be successfully treated through such innovative procedures. In addition, patients who underwent endoscopic procedures had much lower readmissions within 30 days.

Neck Pain Management Starts With an Accurate Diagnosis

Treating neck pain without proper diagnosis is like trying to solve a riddle. Drugs decrease inflammation temporarily, and physical therapy may be useful in cases where there is little structural damage, but neither can repair an annular tear or injury to your cervical disc. Only proper treatment will do the trick, but only once you find out what is causing your pain.

According to our research, many people who suffer from chronic pain have to go through unnecessary treatment procedures ranging from injections to drug therapy, simply because the source of their pain was never determined. At Deuk Spine Institute, we use the Deuk Spine Exam, which combines sophisticated clinical and image-guided diagnostic tests, allowing us to pinpoint the exact source of your pain with 99% accuracy.

If you have been trying to cope with your neck pain for months without success, it’s time for a thorough diagnosis. Book your free MRI review today!

Frequently Asked Questions

How do I know if my neck pain is serious?

Most neck pain does not constitute an emergency situation. In case you are experiencing any of the following: intense pain after an accident, gradually decreasing strength and numbness in the arms or hands, inability to coordinate movements or walk, or changes in bowel and bladder control; then you need immediate attention, because all these could mean that your spinal cord is compressed. According to our results, such situations must be urgently addressed to avoid long-term effects on the nervous system.

How long does it take for neck pain to get better with conservative treatment?

Many people suffering from acute neck pain tend to get better within one to two months by taking adequate rest and using over-the-counter pain medication along with some exercises. However, chronic neck pain usually necessitates the patient go through a rehabilitation program which normally lasts for six to twelve weeks. In our view, when patients do not improve for about three to four months, then we should refer them to an expert.

Is surgery always the last resort for neck pain?

Surgery, on the other hand, is considered when conservative treatment has failed and structural abnormalities that explain the patient’s complaints have been seen on imaging. Nevertheless, there are cases where surgery needs to be done more urgently, like in myelopathy that has progressed to neurological deficit. The objective remains to identify the best way to treat each patient accordingly.

What makes Deuk Laser Disc Repair® different from traditional neck surgery?

Cervical surgeries like ACDF involve removal of the disc along with fusion of the adjacent vertebrae by using screws, rods, and cages made of metal. This surgery involves changes in the biomechanics of the cervical region and has been linked with the development of adjacent segment disease in some percentage of cases. In Deuk Laser Disc Repair®, on the other hand, only 4-millimeter incisions are made, along with the use of a laser and no metal devices. This surgery is done on an outpatient basis and does not require any narcotics after surgery.

Can neck pain cause headaches?

Absolutely. Cervicogenic headaches come from the structures of the neck. This includes the top of the cervical joints, discs, and muscles. And are often confused with tension-type or migraine headaches. As clinicians, we see that cervicogenic headaches usually start with pain on one side of the head, at the back of the head and move up to the front or behind the eye.

Can poor posture cause chronic neck pain?

The forward flexion of the neck for a prolonged period of time due to excessive screen or computer use causes a lot of stress on the cervical spine. With every additional inch that the head is tilted forward, the load on the cervical spine structures increases considerably. Even though the change in posture and ergonomics will help to solve the problems related to the muscles, our research indicates that poor posture leads to faster disc deterioration.

Sources