Some spinal surgeries are performed to remove unusual growths. Other surgical procedures may be effective at relieving spinal pain caused by injury or illness.

Some surgeries are minimally invasive (e.g., arthroscopy) and can be performed at a physician’s office under a local anesthetic. More serious procedures may require the patient to be unconscious and have an extended hospital stay. Rehabilitation involving physical therapy and sometimes occupational therapy may be needed.

Some of the more common spinal surgeries include:

• Discectomy. Removal of all or part of an intervertebral disc. This procedure is one of the more common ways to relieve pain and nerve pressure in the back or neck caused by a herniated disc or bone spur. Percutaneous discectomy, a recently improved variation using a thin tube inserted through a smaller incision, has been found to be effective in relieving some cases of disc herniation and sciatica.
  

• Spinal fusion. Used to strengthen spinal function while preventing painful movements. During this procedure, spinal discs between two or more vertebrae are removed and the bordering vertebrae are fused together by bone grafts and/or devices such as bone screws. Spinal fusion may decrease mobility and usually requires an extended period of recovery. It may be used for conditions including osteoarthritis (OA), rheumatoid arthritis, spinal stenosis, herniated discs and degenerative disc disease.
  
  
• Laminectomy (spinal decompression). The lamina (arched roof of the spinal canal) of one or more vertebrae is removed. By increasing the size of the spinal canal, this procedure may reduce pain by helping alleviate spinal cord and nerve pressure. It may be used for spinal stenosis. Partial removal of a lamina is known as laminotomy.
  
  
• Foraminotomy. Enlarging of the foramen (bony hole) where a nerve root exits the spine. Discs or joints can thicken as people age, causing the place where the spinal nerve exits to narrow. This can press on the nerve, causing pain, numbness or weakness. During this procedure, surgeons cut away the blockage to relieve pressure on the nerve to help conditions such as pinched nerves or sciatica.
  
  
• Vertebroplasty and kyphoplasty. Minimally invasive procedures used to treat vertebral compression fractures, notably those caused by osteoporosis. For both procedures, a type of bone cement is injected into the fractured bone. For kyphoplasty, a balloon is inserted first and inflated to restore the original height of the vertebra, followed by cement. Patients may recover from these relatively new procedures more quickly, with reduced risk of future fractures in the treated bone.
  

• Radiofrequency lesioning. The use of electrical impulses to interrupt pain signals in the body. A needle is inserted into nerve tissue in the pained area with the help of x-rays. The tissue is then heated and temporarily interrupts the nerve’s transmissions. This procedure may be effective at reducing pain for up to 12 months.
  
  
• Rhizotomy. The cutting of spinal nerve roots. Sometimes used to relieve severe chronic pain, this procedure blocks all senses from the affected area.
  
  
• Cordotomy. Disabling of certain pain conductors in the spinal cord to reduce pain and temperature perception. This procedure may be performed on patients with severe cancer pain.
  
  
• Dorsal root entry zone operation (DREZ). Spinal neurons that transmit pain are destroyed surgically. This procedure may be used on patients suffering from paraplegia or experiencing phantom limb pain after an amputation.
  
  
• Implantation of a spinal pump. In severe cases, a pump that delivers pain medication around the spinal cord can be surgically attached to the back.
  
  
• Implantation of a spinal cord stimulator.  In severe cases, especially with nerve pain (e.g., diabetic neuropathy, sciatica), a stimulator around the spinal cord can be surgically implanted.

• Disc replacement. An artificial intervertebral disc may be inserted to restore the separation of two adjacent vertebrae. Made of materials such as metals and plastics, these prostheses can replace an entire disc or just the core (nucleus pulposus). Artificial discs sometimes provide an alternative to spinal fusion and still allow vertebral range of motion. The U.S. Food and Drug Administration (FDA) has approved an artificial disc for treatment of degenerative disc disease, but this newer treatment is not yet commonly performed.

Five years after performing the first transplants of intervertebral discs from humans, Chinese surgeons in 2007 reported long-term success in relieving chronic back pain due to disc degeneration. However, it may take many more years of research before such transplants are approved in the United States.

• Intradiscal electrothermal therapy (IDET). Thermal (heat) energy to treat pain from a bulging or cracked spinal disc or sciatica. An IDET procedure involves inserting a special needle through a catheter into the affected disc and heating it for several minutes, causing the disc wall to seal. This may be effective at reducing disc inflammation and spinal nerve pain. A recent review of 51 clinical studies found that IDET may in many cases offer enough relief to spare patients from more-invasive spinal fusion.
  

• Nucleoplasty. Procedure similar to IDET, but uses radiofrequency to produce heat and treat pain associated with contained or mildly herniated discs. A needle is inserted into the disc to remove painful disc material. The area is then heated to shrink the tissue and seal the disc wall. Multiple insertions may be made depending on how much material needs to be removed. Radiofrequency ablation is also used to remove benign and cancerous spinal tumors.

Researchers are developing additional methods. These include an interspinous implant for spinal stenosis that is still used only experimentally in the United States. In a method called posterior dynamic stabilization surgery, several devices are being studied to bolster the spine and provide a possible alternative to spinal fusion. Balloon cyphoplasty is similar to kyphoplasty but is being used to treat traumatic spinal fractures in younger people rather than osteoporotic fractures.