The type of back surgery your surgeon offers you will depend mainly on your condition. The main types of back surgery include the following.
- Discectomy is a procedure to remove the whole or part of one of the discs between your vertebrae (back bones). Your surgeon may recommend this if the disc has become damaged and is putting pressure on the surrounding nerves. This is sometimes called a herniated or ‘slipped’ disc.
- Laminectomy involves removing a small part of the bone at the back of your vertebra called the lamina. This helps to open up the centre of your spinal column. Your surgeon may suggest this if you have spinal stenosis (a condition in which the space inside your spine narrows). Laminectomy may be done together with discectomy.
- Spinal fusion is a procedure to join two or more of your vertebrae together using bone grafts, screws and rods. It’s used to strengthen and stabilise your spine, and prevent painful movements. Your surgeon may recommend this if you have a condition called spondylolisthesis (when one of your vertebrae slips out of place). They may also suggest spinal fusion for severe degenerative disc disease (when the discs in your spinal cord gradually become worn down).
- Vertebroplasty involves an injection of glue-like bone cement into your vertebra to repair a compression fracture (collapsed vertebra). This may be caused by conditions such as osteoporosis or as the result of trauma. In a similar procedure, called kyphoplasty, your surgeon inserts a special balloon first to lift the vertebra before injecting the cement.
There are other types of back surgery that your surgeon may recommend. They’ll discuss with you what type of surgery is best in your circumstances and explain what’s involved.
Before going into hospital, make some simple preparations for the first few days back home after your surgery. You’ll be able to walk, but you may need to arrange for some help from family or friends. Think about what help you might need with washing, dressing, cleaning and shopping, for instance. You’ll also need to arrange to be picked up from hospital as you won’t be able to drive for a while after your surgery.
Some time before going into hospital you may be called for a pre-operative assessment. This may involve some blood tests and a health check to make sure you’re fit for surgery. If you smoke, your surgeon may ask you to stop well before your surgery. This is because smoking increases your risk of getting a chest and wound infection, which can slow your recovery.
You’ll probably be having a general anaesthetic, so you’ll be asked not to eat or drink anything for about six hours before your operation. It’s important to follow the advice your anaesthetist or your hospital gives you.
Once in hospital you may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anticlotting medicine as well as, or instead of, wearing compression stockings.
Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to ask questions so that you understand what will be happening. You don’t have to go ahead with the procedure if you decide you don’t want it. Once you understand the procedure and if you agree to have it, you’ll be asked to sign a consent form.
If your GP or surgeon suggests back surgery, this is usually because other treatments for back pain have not worked. For most conditions causing back pain, your doctor is likely to suggest alternative treatments before referring you for back surgery. These include:
- painkillers – anti-inflammatory medicines, opioids or tricyclic antidepressants
- exercise guided by physiotherapists
- manual therapies – manipulating and massaging your back
- painkilling injections around your spine
- psychological treatments such as cognitive behavioural therapy (CBT)
- changes to your work or other daily activities
However, there may be reasons why surgery is the best treatment for you before or instead of other treatments. Ask your surgeon to explain your options in your own particular circumstances.
Your back surgery may take between one and three hours. It’s usually carried out under general anaesthesia, which means you’ll be asleep during the procedure.
During the operation you’ll be lying face down so that your surgeon can see your spine. They will make a cut in the skin of your back and pull aside the muscles so that they can work on the affected area. This is known as open surgery. In some cases it may be possible for you to have keyhole surgery instead. Keyhole surgery involves making several small cuts on your back and your surgeon will use special instruments to do the operation.
Exactly how your surgery is carried out will depend on the type you’re having – see our section Types of back surgery for more information. If you want to know more details about the procedure you’re having, ask your surgeon to explain.
After your surgery you’ll be moved to the recovery room where your nurse will monitor you while you wake up fully from the general anaesthetic. You’ll be given pain relief to help as the anaesthetic wears off. Let your nurse know if you are in discomfort.
You’ll probably have an intravenous (IV) line inserted into a vein in your arm. You may have a catheter to drain urine from your bladder into a bag.
With most back surgeries, you’ll spend at least one night in hospital but in some cases this could be four or five. You’ll need to spend some time resting in bed, but will be encouraged to get up and walk around. A physiotherapist (a health professional who specialises in maintaining and improving movement and mobility) may suggest some exercises to help with your mobility and recovery. You may also be given a corset or brace to wear that will support your back.
Your surgeon may close your wound with stitches or staples, which will need to be removed about 10 days after surgery.
Your nurse will give you advice about caring for your back, hygiene and bathing before you go home.
You’ll need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.
Once you’re home, keeping to a normal daily routine of getting up and dressed at the usual time each day will help with your recovery. Try to move around the house, and eat and drink as normal. It’s important to build up your activities gradually, but if you feel tired, stop and rest. You’ll need family and friends to help you with the practical tasks you’ll find difficult for a while such as cooking, cleaning and shopping.
In the first week or two you may still need some pain relief. You can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Your physiotherapist will show you exercises to do while you recover. These will help you get back your strength and movement and avoid stiffness. It’s important to follow your physiotherapist’s advice.
Your surgeon may ask you to restrict certain activities and movements for a period after your surgery. For instance, they may advise you to avoid heavy lifting, awkward twisting or bending forward to do everyday tasks for four weeks. They may also recommend that you don’t sit or stand in one position for more than 20 minutes. These restrictions may depend on what type of surgery you had. For instance, recovery from spinal fusion can take longer than for other types of spinal surgery. Always follow your surgeon’s advice.
After you’ve been at home for about two weeks you can go for short walks – 10 minutes in the morning and again in the afternoon. After six weeks you can start swimming, or doing other gentle exercise that doesn’t put stress on your spine. You may be able to do most activities as normal by 12 weeks, except contact sports. If you want to know more about resuming particular sporting activities ask your surgeon.
You may be able to start driving again after about six weeks. However, you shouldn’t drive until you can safely control your vehicle, including doing an emergency stop. Don’t drive if your painkillers make you drowsy. Tell your motor insurance company about your operation and check what your policy says about driving after surgery.
Time off work depends on the type of surgery you’ve had and what your job involves. Most people can return to work after about four to six weeks. If your job involves driving, heavy lifting or other strenuous activity you may need 12 weeks off. Ask your surgeon or occupational health team what’s best in your circumstances.
Having an operation can take a lot out of you so you may feel tired and a little upset or emotional after your surgery. Don’t worry, this is quite normal. Having company, and getting back to work as soon as you’re able to, should help.
Every surgical procedure can have side effects. Side-effects are the unwanted but mostly temporary effects you may get after the procedure, for example, feeling sick as a result of the general anaesthetic.
After back surgery you’ll feel some discomfort in your back and around your wound. You may get times when you feel very tired suddenly and this may happen for up to six weeks after your surgery. Ask your surgeon if you have any concerns about possible side effects of your back surgery.
Complications are when problems occur during or after your operation. All surgical procedures come with some risks, but how these risks apply to you will be different to how they apply to others. Ask your surgeon about the chances of complications in your circumstances.
Some complications can happen after any major operation. For example, you might develop a chest infection, especially if you smoke. There’s also always a chance you might get a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
Complications specific to back surgery depend upon the type of surgery you have but may include the following.
- Infection of your wound or, rarely, the tissues around your spine. If you get an infection this can be treated with antibiotics. Contact your GP if you have increasing pain, redness, tenderness or swelling around your wound or if you get a high temperature.
- Bleeding during your operation. If you lose a lot of blood you may need a transfusion.
- Damage to the nerves at the site of your surgery. This may be temporary or may cause long-lasting pain.
- Tearing of the membrane covering your spine. The watery fluid that surrounds your spinal nerves (cerebrospinal fluid, CSF) can leak out. Your surgeon will mend the tear if they see it during surgery. Sometimes this tear causes headaches afterwards but these usually improve with time.
- Recurring symptoms or, in the case of a slipped disc, another slipped disc happening. This means you may continue to have symptoms after your surgery, and may need further surgery.
If you have concerns about possible complications of your back surgery, discuss these with your surgeon. Contact your GP if you have ongoing or worsening pain, numbness or muscle weakness which is new to you, or problems passing urine.
Is there anything I can do to help my recovery? Is there anything I can do to help my recovery after back surgery?
Yes, there are lots of different things you can do to help your back recover after surgery. Eat healthily, stop smoking, accept help from family and friends, keep a routine and build up activities gradually.
Your surgeon or physiotherapist may suggest some exercises or general things you can do around your home to help you recover after back surgery. These may include the following.
- Eat a well-balanced diet to give your body the nutrition it needs to heal and stay healthy.
- If you smoke, try hard to stop, even if it’s just during the time that you’re recovering. This will improve your circulation and breathing and help you to heal.
- Accept help from family and friends. You’ll need them at first anyway to assist with the tasks you can’t manage, and their company will help keep your spirits up.
- Set a daily routine and keep to it. Get up and dressed at the usual time each day, even if you have to rest later. Try to move around the house as normal, taking it easy at first.
- Gradually build up your normal activities. Have a go at doing some of the things you’d normally do, but be careful to rest if you become tired.
- Aim to get back to work as soon as you safely can. This will help stop you feeling isolated and low caused by being at home alone for long periods.
Give yourself time and expect to feel tired and even emotional sometimes. Rest when you’re tired but gradually build back to your normal daily life. Remember, everyone recovers at their own speed and in their own way.
Yes, after a while. From about 12 weeks after surgery most people will be back to their normal activities. This includes most sports, except contact sports. Ask your surgeon what they recommend in your circumstances.
From two weeks after your back surgery you can usually start taking short walks. From about six weeks you may be able to start activities which cause the least strain and pressure on your spine, such as swimming. Depending on the type of surgery you had, you may be able to be back to normal activities after 12 weeks. You won’t be ready to take up contact sports yet, though.
If sports are important to you discuss this with your surgeon at the time of your operation. They’ll be able to give you the best advice about when and how to take up your particular sport again. It’s important to follow the advice you’re offered.
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