Spine surgery is usually not necessary for the majority of patients experiencing spinal or back pain. However, certain painful conditions may be treated with spine surgery if necessary. These include:

• Spinal cord injuries. Damage to the spinal cord from either direct injury to the cord itself or indirect injury from damage to the bones and soft tissues surrounding the spinal cord. Spinal cord trauma is the most common reason for spinal surgery. The many causes of such trauma include motor vehicle accidents, diving into shallow water, athletic injuries and violent crime.
  
  
• Disc conditions. The intervertebral discs provide cushioning for the vertebrae. Disorders of these discs include:
  
  

  • Herniated disc. Occurs when a disc protrudes into the spinal canal and may rupture.
    
    
  • Degenerative disc disease. Occurs when discs break down from age or injury and may cause pain and require surgery.
    
    
• Spinal stenosis. Narrowing of the nerve openings along the spinal canal, particularly in the lower (lumbar) back, that may cause debilitating pain. Spinal stenosis pain occurs when the cushioning discs between vertebrae shrink and affect the nerve openings, causing nerve impingement. It may be associated with numbness, tingling or weakness in the affected area.
  
  
• Several types of arthritis, including:
  
  
  • Osteoarthritis. The most common form of arthritis. Osteoarthritis is caused by the breakdown of joint cartilage over time and is most common in people over the age of 45. Even though osteoarthritis is more common in other joints, it may affect the lumbar region of the spine. Surgery that joins two bones (spinal fusion) may be used to treat osteoarthritis in some cases.
    
    
  • Rheumatoid arthritis (RA). Inflammation of the joints. Some RA patients have inflammation in the joints in the neck, which may eventually affect the stability of the spine.
    
    
  • Ankylosing spondylosis. Bony overgrowths associated with aging of the spine. These overgrowths often cause back pain but may also cause neck pain. Surgery may be required to treat spondylosis in some cases.
    
    
• Osteoporosis.  A disorder where the bones lose density. Some osteoporosis patients experience vertebral fractures that are may be addressed surgically.

• Scoliosis. Abnormal sideways curvature of the spine usually found in adolescents.  Spinal surgery may be advised for scoliosis patients who are still growing, have a curve greater than 45 degrees or have a curve that is growing progressively worse. However, most patients with scoliosis do not require surgery.
  
  
• Spina bifida. A birth defect in which the backbone and spinal canal do not close before birth. In some cases, the spinal cord and its covering membranes may protrude out of an infant’s back, a condition requiring surgery.
  
  
• Syringomyelia. Formation of a fluid-filled cyst (syrinx) in the spinal cord. A syrinx may enlarge over time and cause damage to the spinal cord. Surgery may be used to drain a syrinx in some instances.
  
  
• Pinched nerves. Malfunctioning of nerves usually due to impingement between a bone and a ligament or between a bone and tendon. In some cases spinal surgery is used to remove scar tissue, an intervertebral disc or bone spurs.
  
  
• Sciatica. Pain, weakness, numbness or tingling that affects one or both legs and originates from the sciatic nerves, often because of a herniated disc. Noninvasive treatments such as exercise, thermotherapy and over-the-counter medications usually relieve sciatica, but surgery might be an option if pain or weakness keep worsening.
  
  
• Whiplash. An injury to the neck resulting from a sudden jerking of the head. Noninvasive treatments help most patients recover from whiplash, but in rare cases surgery is used.