When Surgery Is An Option: Back Pain

Content provided by the Faculty of the Harvard Medical School

When surgery is an option

Only certain types of back problems benefit from surgical intervention. Your doctor may recommend surgery if you are suffering from a herniated disk, cauda equina syndrome, spinal stenosis, a spinal compression fracture, or spondylolisthesis, and if other, less invasive methods have not provided sufficient relief. Surgery is also used to treat an infection that has not responded to other treatments, a tumor, or an injury that has caused severe damage to vertebrae and the spinal cord.

To determine whether you are a candidate for surgery, you and your doctor first need to consider whether you meet certain criteria. If you have cauda equina syndrome or some other emergency situation, your doctor may recommend surgery right away.

For chronic back pain, your doctor is most likely to recommend surgery if you have been in substantial distress for a sufficient period — usually a minimum of six weeks — to convince both of you that more conservative approaches won't provide a cure. In cases of nerve-compression problems, you'll need clear evidence that nerve-root function is impaired. And a reliable imaging procedure, such as a CT scan or MRI, must show that a surgically correctable anatomical abnormality is causing pressure on a nerve root; if diagnostic tests do not reveal clear signs of pressure on a particular nerve, the origin of the low back pain may lie elsewhere in the body.

But, unless you are the victim of a traumatic accident and require emergency surgery, or have an infection, tumor, or serious nerve compression problem, the decision to have back surgery is yours to make. This means that you need to carefully consider all the risks and benefits involved.

Last updated:	January 23, 2007