Spine Surgery

Spine surgery can relieve pain and help you regain function when non-surgical treatments can’t help

Spine surgery can relieve symptoms caused by compressed nerves and help you regain function. It involves many techniques — some minimally invasive — to help restore your quality of life.

We only recommend spine surgery if we believe it will help and other conservative treatments have not provided long-term relief.

Spine surgery provides symptom relief by taking pressure off affected nerves. Many spine procedures can do this. Your surgeon will look at the cause of your pain and other factors to determine the best one for you.

During spine surgery, your medical team will:

  1. Put you to sleep with anesthesia
  2. Take precautions to protect your nervous system, which may include actively monitoring your spinal cord and nerve function (neuromonitoring) throughout the procedure
  3. Remove overgrown bone or a herniated disc or realign a structural deformity to decompress your nerve(s) or spinal cord. Sometimes, we also add instrumentation (such as rods and screws) to stabilize the spine.

It’s important to have the right expectations before spine surgery. Your surgeon should clearly explain what to expect for your specific situation, including:

  • Which symptoms will improve and when
  • Which symptoms will stay the same
  • What your recovery will be like in the hospital and at home
  • If you will need to go to rehab or physical therapy

Should You Get Spine Surgery?

It’s important to try any recommended non-surgical treatments before considering spine surgery. Most neck and back pain resolves with time and more conservative methods. Those may include changes in how you do certain activities, anti-inflammatory medications, physical therapy and steroid injections.

You may be a candidate for spine surgery if:

  • Conservative measures have failed.
  • Imaging shows evidence of pressure on a nerve (nerve root compression) or spinal cord compression that can be fixed surgically.
  • You have instability in your spinal vertebrae that can be stabilized with surgery.
  • You have a structural deformity of the spine.
  • You have a tumor that needs to be removed.

Conditions that may benefit from spine surgery include:

Types of Spine Surgery

At IU Health, we offer the full range of spine surgeries — from minimally invasive to traditional, open operations. Some common procedures include:

Lumbar spine (lower back) operations

  • Microdiscectomy: This procedure provides relief for sciatica. Sciatica results from a pinched nerve in the lumbar spine that causes leg pain. Surgeons remove the part of a herniated disc that is putting pressure on the affected nerve(s).
  • Laminectomy: Laminectomy treats spinal narrowing from conditions like lumbar spinal stenosis. Lumbar stenosis happens when the spinal canal narrows in your lower back after arthritis causes bone and ligaments to overgrow. Surgeons make room in the spinal canal and relieve pressure on spinal nerve roots by removing bone and overgrown ligaments. Ligaments are bands of elastic tissue that connect bones to each other.

Spinal fusions

Spinal fusion surgery stabilizes your spine. We offer different spinal fusion options to better tailor treatment to your specific anatomy and condition.

During spinal fusion:

  1. Your surgeon may insert rods and screws or plates and screws (instruments) into the vertebrae to stabilize a segment of your spine.
  2. Your own bone is typically combined with bone from a bone bank (a place that has donor bones and tissues) and placed across the segments that have instruments in them.
  3. Your body connects these bones so they act as one bone (fusion). This fusion provides long-term stability across the affected area of the spine.

Some people need only a single level of fusion. Others, such as those with scoliosis, need multiple fusions to stabilize the segment.

Neck surgeries

Anterior cervical discectomy and fusion (ACDF)

This procedure takes pressure off the spinal cord and/or nerves in the cervical spine that are compressed due to arthritis. ACDF involves several steps, including:

  1. Surgeons remove damaged disc(s) and bone spurs to relieve spinal cord or nerve root pressure.
  2. They then place a graft in place of the disc that eventually fuses the two bones together.
  3. Surgeons also use a plate and screws at the same time to stabilize the vertebrae while they fuse.

Disc replacements

Some patients may be candidates for cervical disc replacements. These procedures can keep you active and decrease the likelihood of future surgeries. In these procedures:

  1. Surgeons decompress the spinal cord and/or nerve roots.
  2. They then put an artificial disc in the place of the affected disc(s) instead of a graft with plate and screws.
  3. The artificial disc allows you to maintain movement in the affected parts of your spine.

An artificial disc can’t be used for all causes of spinal cord or nerve root compression. But when it is appropriate, we offer it as an option.

Other spine surgeries

  • Tumor resection (removal)
  • Sagittal realignment procedures to treat sagittal imbalance (abnormal spine curvature)
  • Minimally invasive procedures (involving smaller incisions and shorter recoveries)

Spine Surgery: What to Expect

Spine surgery provides symptom relief by taking pressure off affected nerves. Many spine procedures can do this. Your surgeon will look at the cause of your pain and other factors to determine the best one for you.

During spine surgery, your medical team will:

  1. Put you to sleep with anesthesia
  2. Take precautions to protect your nervous system, which may include actively monitoring your spinal cord and nerve function (neuromonitoring) throughout the procedure
  3. Remove overgrown bone or a herniated disc or realign a structural deformity to decompress your nerve(s) or spinal cord. Sometimes, we also add instrumentation (such as rods and screws) to stabilize the spine.

It’s important to have the right expectations before spine surgery. Your surgeon should clearly explain what to expect for your specific situation, including:

  • Which symptoms will improve and when
  • Which symptoms will stay the same
  • What your recovery will be like in the hospital and at home
  • If you will need to go to rehab or physical therapy

Should You Get Spine Surgery?

It’s important to try any recommended non-surgical treatments before considering spine surgery. Most neck and back pain resolves with time and more conservative methods. Those may include changes in how you do certain activities, anti-inflammatory medications, physical therapy and steroid injections.

You may be a candidate for spine surgery if:

  • Conservative measures have failed.
  • Imaging shows evidence of pressure on a nerve (nerve root compression) or spinal cord compression that can be fixed surgically.
  • You have instability in your spinal vertebrae that can be stabilized with surgery.
  • You have a structural deformity of the spine.
  • You have a tumor that needs to be removed.

Conditions that may benefit from spine surgery include:

Types of Spine Surgery

At IU Health, we offer the full range of spine surgeries — from minimally invasive to traditional, open operations. Some common procedures include:

Lumbar spine (lower back) operations

  • Microdiscectomy: This procedure provides relief for sciatica. Sciatica results from a pinched nerve in the lumbar spine that causes leg pain. Surgeons remove the part of a herniated disc that is putting pressure on the affected nerve(s).
  • Laminectomy: Laminectomy treats spinal narrowing from conditions like lumbar spinal stenosis. Lumbar stenosis happens when the spinal canal narrows in your lower back after arthritis causes bone and ligaments to overgrow. Surgeons make room in the spinal canal and relieve pressure on spinal nerve roots by removing bone and overgrown ligaments. Ligaments are bands of elastic tissue that connect bones to each other.

Spinal fusions

Spinal fusion surgery stabilizes your spine. We offer different spinal fusion options to better tailor treatment to your specific anatomy and condition.

During spinal fusion:

  1. Your surgeon may insert rods and screws or plates and screws (instruments) into the vertebrae to stabilize a segment of your spine.
  2. Your own bone is typically combined with bone from a bone bank (a place that has donor bones and tissues) and placed across the segments that have instruments in them.
  3. Your body connects these bones so they act as one bone (fusion). This fusion provides long-term stability across the affected area of the spine.

Some people need only a single level of fusion. Others, such as those with scoliosis, need multiple fusions to stabilize the segment.

Neck surgeries

Anterior cervical discectomy and fusion (ACDF)

This procedure takes pressure off the spinal cord and/or nerves in the cervical spine that are compressed due to arthritis. ACDF involves several steps, including:

  1. Surgeons remove damaged disc(s) and bone spurs to relieve spinal cord or nerve root pressure.
  2. They then place a graft in place of the disc that eventually fuses the two bones together.
  3. Surgeons also use a plate and screws at the same time to stabilize the vertebrae while they fuse.

Disc replacements

Some patients may be candidates for cervical disc replacements. These procedures can keep you active and decrease the likelihood of future surgeries. In these procedures:

  1. Surgeons decompress the spinal cord and/or nerve roots.
  2. They then put an artificial disc in the place of the affected disc(s) instead of a graft with plate and screws.
  3. The artificial disc allows you to maintain movement in the affected parts of your spine.

An artificial disc can’t be used for all causes of spinal cord or nerve root compression. But when it is appropriate, we offer it as an option.

Other spine surgeries

  • Tumor resection (removal)
  • Sagittal realignment procedures to treat sagittal imbalance (abnormal spine curvature)
  • Minimally invasive procedures (involving smaller incisions and shorter recoveries)

Our spine surgeons have the expertise to handle all spine conditions using different methods. These skills allow them to personalize care to your health and circumstances — whether you’re a 25-year-old athlete or an 85-year-old grandparent.

You also benefit from our:

  • Affiliation with the IU School of Medicine: We have the only neurosurgery residency program in Indiana through the IU School of Medicine. This affiliation means doctors plan your care using the latest treatments and are involved in research which keeps them at the cutting edge.
  • Outcomes reporting: We participate in national patient registries, which helps us track and learn from patient outcomes. This data helps us ensure that our procedures remain beneficial long after discharge. It also shows that the quality of our care is on par with other top institutions.
  • Advanced technology: The latest instruments and technology help make our operations safer. For example, our spine surgeons use image-guidance to precisely place pedicle screws. This technology shows where they’re putting screws in real time on a 3D model, with better accuracy than other techniques.

Spine Surgery at IU Health

Our spine surgeons have the expertise to handle all spine conditions using different methods. These skills allow them to personalize care to your health and circumstances — whether you’re a 25-year-old athlete or an 85-year-old grandparent.

You also benefit from our:

  • Affiliation with the IU School of Medicine: We have the only neurosurgery residency program in Indiana through the IU School of Medicine. This affiliation means doctors plan your care using the latest treatments and are involved in research which keeps them at the cutting edge.
  • Outcomes reporting: We participate in national patient registries, which helps us track and learn from patient outcomes. This data helps us ensure that our procedures remain beneficial long after discharge. It also shows that the quality of our care is on par with other top institutions.
  • Advanced technology: The latest instruments and technology help make our operations safer. For example, our spine surgeons use image-guidance to precisely place pedicle screws. This technology shows where they’re putting screws in real time on a 3D model, with better accuracy than other techniques.

The more strength you have before surgery, the quicker you’ll be able to recover. To prepare for your procedure, you should:

  • Optimize your general health to lower your risk for complications, including eating a healthy diet and making sure blood sugar levels are under control
  • Improve your fitness, including strengthening your core and other muscles
  • Regularly stretch
  • Work with a physical therapist to develop a personalized plan to minimize wear and tear on your spine, decrease pain and increase function
  • Prepare your home and life so you can focus on your recovery
  • Quit smoking as soon as possible

Preparing for Spine Surgery

The more strength you have before surgery, the quicker you’ll be able to recover. To prepare for your procedure, you should:

  • Optimize your general health to lower your risk for complications, including eating a healthy diet and making sure blood sugar levels are under control
  • Improve your fitness, including strengthening your core and other muscles
  • Regularly stretch
  • Work with a physical therapist to develop a personalized plan to minimize wear and tear on your spine, decrease pain and increase function
  • Prepare your home and life so you can focus on your recovery
  • Quit smoking as soon as possible

Each spine procedure has its own recovery process. Some patients, such as those undergoing microdiscectomy, go home the same day as their procedure. Others, such as those who need spinal fusions, face a three- to six-month recovery.

Your care team will let you know what to expect — and what is expected of you. Usually, we encourage active recoveries where you get up, stretch and walk around every hour or so.

After Spine Surgery

Each spine procedure has its own recovery process. Some patients, such as those undergoing microdiscectomy, go home the same day as their procedure. Others, such as those who need spinal fusions, face a three- to six-month recovery.

Your care team will let you know what to expect — and what is expected of you. Usually, we encourage active recoveries where you get up, stretch and walk around every hour or so.

Use this list as a starting point for any questions you may have. Be sure to write them down and bring them to your office visit:

  • Why do I need this surgery?
  • Are there any options I haven’t tried?
  • How long will the surgery take and what are the risks?
  • How will you know if it’s successful?
  • Will I be able to resume my normal activities after the surgery? Will there be any activities I should avoid?

Questions to Ask Your Doctor About Spine Surgery

Use this list as a starting point for any questions you may have. Be sure to write them down and bring them to your office visit:

  • Why do I need this surgery?
  • Are there any options I haven’t tried?
  • How long will the surgery take and what are the risks?
  • How will you know if it’s successful?
  • Will I be able to resume my normal activities after the surgery? Will there be any activities I should avoid?

Patient Stories for Spine Surgery