Navigation

Back surgery


Expert reviewer, Mr Roger Tillman, Orthopaedic Surgeon
Next review due November 2023

Back surgery is recommended as a treatment for back pain in certain circumstances. For most people, non-surgical treatments including painkillers, physiotherapy, injections and psychological therapies help ease back pain. You’ll only have back surgery if these treatments don’t help and your doctor knows surgery would help your condition. If your GP thinks surgery might help, they'll refer you to a spinal surgery centre for assessment.

An image showing the different parts of the spine

Different types of back surgery

The type of back surgery your surgeon recommends will depend on what’s causing your pain. Some surgery helps to relieve back pain caused by wear and tear or osteoporosis. Other types can help if you have severe pain spreading down your leg (sciatica), caused by pressure on the nerves in your spine.

The most common types of back surgery are described below. There are others that your surgeon may recommend. They’ll discuss which type of surgery is best in your circumstances and explain what’s involved.

An image showing a section of the


Lumbar decompression

Lumbar decompression (or spinal decompression) relieves pressure on trapped nerves that are causing pain in your back or legs. Decompression involves either discectomy, laminectomy or both.

Discectomy is partial or complete removal of a disc between your vertebrae (the bones in your spine). Your surgeon may recommend this if a disc is damaged and pressing on surrounding nerves. This is often called a herniated or ‘slipped’ disc. If the whole disc is removed, your surgeon may suggest replacing it with an artificial disc. This makes the operation more complex so your surgeon will discuss whether this is suitable in your case.

Laminectomy involves removing a small piece of bone at the back of a vertebra, called the lamina. This opens up the centre of your spinal column to relieve pressure on the nerve. Your surgeon may suggest it for spinal stenosis – a condition which causes narrowing of your spinal canal.

Spinal fusion

This procedure joins two or more vertebrae together using bone grafts, screws and rods. It strengthens and stabilises your spine, and prevents painful movement. Your surgeon may recommend this:

  • along with decompression surgery if one of your vertebrae slips out of place
  • if your spine is unstable
  • if the discs between the vertebrae in your spine are worn down (severe disc degeneration)
  • for scoliosis, where your spine bends to one side

Vertebroplasty and kyphoplasty

Vertebroplasty involves injecting glue-like bone cement into your vertebra to repair a compression fracture (collapsed vertebra). This may be caused by osteoporosis or injury. A similar procedure (called kyphoplasty) involves putting a special balloon in first, to lift the vertebra before injecting the cement.

Newer techniques

There are new methods for back surgery that are less invasive than standard techniques. This might mean less extensive surgery or avoiding open surgery altogether. Newer procedures include:

  • percutaneous coblation – using a heated probe inserted through a needle to destroy a damaged disc
  • percutaneous endoscopic discectomy – removing tissue from a damaged disc using instruments inserted through a small cut or needle in your back

New techniques need a lot of testing and monitoring to see how well they work before they can become common practice. Only some surgeons with specific training and expertise will offer them.

Deciding on back surgery

You'll meet your surgeon or someone from their team before the operation day. They’ll run through any other treatment options and ensure you understand the expected outcome of surgery. They'll discuss what will happen before, during and after your procedure, and any pain or possible complications you might have.

This is your opportunity to ask questions, so you understand what will happen. You don’t have to go ahead if you decide you don’t want surgery. You may prefer to keep trying non-surgical treatments such as exercise, manual and psychological therapies. If you do decide to go ahead, you’ll be asked to sign a consent form.

Preparing for back surgery

Before your operation

Before your operation, it's worth preparing for your first days at home after surgery. You may need some help from family or friends. In most cases, you’ll be able to walk after your operation. However, with some procedures you’ll need time resting in bed first. Even if you’re up and walking, you may need help with washing, dressing, cleaning and shopping. If you live alone, you may need someone to stay with you for the first few days. You’ll also need to be collected from hospital because you won’t be able to drive for a while.

Before going into hospital, you'll probably have a pre-operative assessment. This involves a general health check to make sure you’re fit, and possibly blood tests and an ECG. If you smoke, your surgeon may ask you to stop. Smoking increases your risk of a chest or wound infection and delays healing.

If you're having open surgery, you'll probably have a general anaesthetic. This means you won’t be able to eat or drink anything for about six hours before surgery. It’s important to follow the advice your anaesthetist gives you.

On the day

Once in hospital, you may be given compression stockings to help prevent blood clots forming in the veins in your legs. You may also have an injection of an anticlotting medicine.

Your surgeon will check that you've signed the consent form and are still happy to go ahead.

What happens during back surgery

Decompression surgery and spinal fusion

These procedures are usually carried out by open surgery. After taking X-rays to find the affected area of your back, your surgeon makes a cut into your back and pulls the muscles aside to reach your spine. The surgery usually takes between one and three hours, depending on exactly what’s being done. It’s usually carried out under general anaesthesia, which means you’ll be asleep throughout.

In decompression surgery, the surgeon will remove sections of bone, ligaments and disc to free up the nerves in your back. You may be able to have a smaller operation where only part of a vertebra is removed. If bone is removed, this is called a laminectomy. If only disc material is removed, it is called a micro-discectomy.

In spinal fusion, your surgeon inserts a bone graft (a small piece of bone) between two bones in your spine (vertebrae) to fuse them together. The graft may be from elsewhere in your body, from donated bone, or it may be artificial. You may have plates, screws and rods to keep your spine still while the bones fuse.

Vertebroplasty and kyphoplasty

These procedures are used to fix compression fractures, usually from osteoporosis, and to strengthen bone to prevent future fractures. You have this done using a needle inserted into your back.

You may have a general or local anaesthetic. If you have a local anaesthetic, you will be awake during the operation, but your doctor will offer you medication to relax you. You lie face down and your surgeon puts the needle into the affected area of your back, guided by X-ray. Your surgeon then injects cement into the broken bone. With kyphoplasty, your surgeon will temporarily put in a balloon to make space for the cement.

What to expect afterwards

After surgery, you’ll be moved to the recovery room where your nurse will monitor you until you’re fully awake. You’ll have pain relief to help as the anaesthetic wears off.

You’ll probably have an intravenous (IV) drip in a vein in your arm. You may have a catheter in your bladder, draining your urine into a bag. You'll have a dressing over your wound.

With most back surgeries, you’ll spend a couple of nights in hospital. You’ll need to spend some time resting in bed, but will be encouraged to get up and walk around.

Your nurse will give you advice about caring for your back and looking after your wound before you go home. A physiotherapist or your surgeon will give you some exercises to help mobility and recovery.

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.

Recovering from back surgery

Recovery time depends on the type of surgery you've had. It also varies widely from person to person. For standard decompression surgery, you would normally expect to be pain free and able to exercise gently after 6 weeks. You should be back to most normal activities within 12 weeks.

It can take several months for bone to grow after spinal fusion. You'll be taught how to move in a way that keeps your spine aligned during this time. You’ll have physiotherapy and will be able to gradually increase your activities.

For vertebroplasty and kyphoplasty, you should be back to usual activities straight away. Techniques that don't involve open surgery have a quicker recovery time.

Getting over open surgery

Recovering from open surgery takes longer than getting over less invasive procedures. Getting home and back to normal will help. Try to keep moving, building up your activities gradually. If you feel tired, stop and rest. To start with, you’ll need help with practical tasks such as cooking, cleaning and shopping.

Having an operation can take a lot out of you, so you may feel tired and a little emotional. Don’t worry, this is completely normal. Many people feel like this and having company from family and friends will help you recover.

It's important to keep moving. Doing your physiotherapy exercises will help you regain strength and movement and avoid stiffness. Your surgeon or physiotherapist may tell you to avoid some activities and movements. For up to four weeks, you may need to avoid:

  • heavy lifting
  • twisting
  • bending forward
  • sitting or standing in one position for too long

Aim to build up the amount of exercise you do, starting with light exercise and gradually getting back to normal. To find out about playing sports, see our FAQ below: Will I be able to play sports after my back surgery?

Pain relief and looking after your wound

In the first weeks after surgery, you may still need 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.

You'll have a dressing over your wound when you come home. Wash carefully around this to keep it dry. Your stitches or staples will be removed about 10 days after surgery. After that, you can bath and shower as normal. When the wound has healed, you'll have a small scar.

Driving

You can usually start driving again about six weeks after surgery. But don’t drive if painkillers make you drowsy or before you can safely control your vehicle, including doing an emergency stop. Tell your insurance company about your operation and check what your policy says about driving after surgery.

Getting back to work

This depends on the surgery you’ve had and on your job. Most people can return to work after about four to six weeks. If your job is strenuous or involves driving or heavy lifting you may need up to 12 weeks off. Ask your surgeon or occupational health team.

Self-help

  • Eat a well-balanced diet to give your body the nutrition it needs to heal.
  • If you smoke, stop – even if it’s just while you recover. This will help healing and reduce the risk of complications.
  • Let family and friends help with tasks you can’t manage – the company may help lift your spirits too.
  • Stick to a daily routine but rest when you need to.
  • Gradually build up to normal activities doing more as you’re able to, but don't overdo it.
  • Get back to work as soon as you safely can – talk to your employer about starting with lighter duties if necessary.
  • Stay positive. Everyone recovers at their own speed and in their own way – you're bound to feel tired and even emotional sometimes.

Complications of back surgery

Complications are problems occurring during or after surgery. All procedures come with some risks, but can vary from person to person. Ask your surgeon about the chances of complications in your circumstances.

After any major operation there is a risk of chest infection or wound infection, especially if you smoke. There’s also risk of a blood clot, usually in a vein in your leg (deep vein thrombosis, DVT). Your surgeon will minimise these risks as far as possible.

Complications specific to back surgery depend on the type of surgery but may include the following.

  • An infection of your wound or, rarely, the tissues around your spine. Contact your GP if you have increasing pain, redness, tenderness or swelling around your wound or have a fever – you may need antibiotics.
  • Bleeding – if you lost a lot of blood during surgery, you may need a transfusion.
  • Damage to nerves, blood vessels or other tissues may occur. If the membrane covering your spine is damaged, the fluid surrounding your spinal cord (cerebrospinal fluid, CSF) can leak out. Your surgeon will mend this during surgery. A tear can cause headaches afterwards but these usually improve with time.
  • A swelling of blood (haematoma) near your wound– this may need draining.
  • After spinal fusion, the graft, rods and screws may break or move out of place. This needs another operation to repair it. You may also need a second operation if not enough bone forms.
  • With vertebroplasty and kyphoplasty, the cement may leak or you may have a reaction to it.
  • If your symptoms recur after surgery or you have another slipped disc, for example, you may need further surgery.

Discuss any concerns you have about complications with your surgeon. After you go home, contact the hospital if you have:

  • a high temperature
  • ongoing or worsening pain
  • numbness or muscle weakness which is new
  • problems passing urine

Frequently asked questions

  • Yes, you usually can but only after your spine has recovered. About 12 weeks after surgery, most people will be back to normal activities. This includes everything other than contact sports.

    Two weeks after surgery, you can usually start taking short walks – try 10 minutes in the morning and again in the afternoon. After six weeks, you may be able to start activities such as swimming, which cause very little strain and pressure on your spine.

    If sport is important to you, talk to 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 particular sports again. It’s important to follow their advice.

Back pain quiz

How much do you know about taking care of your back? Take our short quiz to test your knowledge.


Did our information help you?

We’d love to hear what you think. Our short survey takes just a few minutes to complete and helps us to keep improving our health information.


About our health information

At Bupa we produce a wealth of free health information for you and your family. This is because we believe that trustworthy information is essential in helping you make better decisions about your health and wellbeing.

Our information has been awarded the PIF TICK for trustworthy health information. It also complies with the HONcode standard and follows the principles of the The Information Standard.

The Patient Information Forum tick  This website is certified by Health On the Net Foundation. Click to verify.

Learn more about our editorial team and principles >

Related information

    • Low back pain and sciatica in over-16s: assessment and management. National Institute for Health and Care Excellence (NICE), November 2016. www.nice.org.uk
    • Musculoskeletal lower back pain. BMJ Best Practice. bestpractice.bmj.com, last reviewed March 2018
    • Low back pain and sciatica. Patient. patient.info, last edited 7 December 2016
    • Spinal stenosis. BMJ Best Practice. bestpractice.bmj.com, last reviewed January 2017
    • Discogenic low back pain. BMJ Best Practice. bestpractice.bmj.com, last reviewed December 2017
    • Osteoporotic spinal compression fractures. BMJ Best Practice. bestpractice.bmj.com, last reviewed December 2017
    • Sciatica (lumbar radiculopathy). NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised February 2017
    • Spinal decompression and fusion. Medscape. emedicine.medscape.com, updated 3 April 2017
    • Spinal disc problems. Patient. patient.info, last edited 12 Feb 2016
    • Spinal fusion. OrthoInfo. American Academy of Orthopaedic Surgeons. orthoinfo.aaos.org, last reviewed June 2010
    • Scoliosis. BMJ Best Practice. bestpractice.bmj.com, last reviewed October 2016
    • Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for treating osteoporotic vertebral compression fractures. National Institute for Health and Care Excellence (NICE), April 2013. www.nice.org.uk
    • Good surgical practice. The Royal College of Surgeons. www.rcseng.ac.uk, published September 2014
    • Get Well Soon. Helping you to make a speedy recovery after a slipped disc operation. Royal College of Surgeons. www.rcseng.ac.uk, accessed 14 February 2018
    • Pre-operative assessment – examination and tests. Patient. patient.info, last edited 23 February 2016
    • Routine preoperative tests for elective surgery. National Institute for Health and Care Excellence (NICE), April 2016. www.nice.org.uk
    • Preparing for low back surgery. OrthoInfo. American Academy of Orthopaedic Surgeons. orthoinfo.aaos.org, last reviewed January 2018
    • Lumbar discectomy. Medscape. emedicine.medscape.com, updated 22 September 2015
    • Prevention of venous thromboembolism. Patient. patient.info, last edited 13 June 2014
    • Overdevest GM, Jacobs W, Vleggeert-Lankamp C, et al. Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis. Cochrane Database of Systematic Reviews 2015: 19(3). doi:10.1002/14651858.CD010036.pub2
    • Spinal fusion. OrthoInfo. American Academy of Orthopaedic Surgeons. orthoinfo.aaos.org, last reviewed June 2010
    • Spinal instability and spinal fusion surgery – treatment and management. Medscape. medicine.medscape.com, updated 13 January 2016
    • Osteoporosis and spinal fractures. OrthoInfo. American Academy of Orthopaedic Surgeons. orthoinfo.aaos.org, last reviewed January 2016
    • Percutaneous coblation of the intervertebral disc for low back pain and sciatica. National Institute for Health and Care Excellence (NICE), January 2016. www.nice.org.uk
    • Percutaneous interlaminar endoscopic lumbar discectomy for sciatica. National Institute for Health and Care Excellence (NICE), April 2016. www.nice.org.uk
    • Percutaneous transforaminal endoscopic lumbar discectomy for sciatica. National Institute for Health and Care Excellence (NICE), April 2016. www.nice.org.uk
    • Common postoperative complications. Patient. patient.info, last edited 27 July 2016
    • Personal communication, Roger Tillman, Orthopaedic Surgeon, November 2020
  • Reviewed by Liz Woolf, Freelance Health Editor, November 2020
    Expert reviewer, Mr Roger Tillman, Orthopaedic Surgeon
    Next review due November 2023

ajax-loader