Spine surgeries are operations on parts of the spine—the bones and joints in the back and neck. These bones hold and protect the spinal cord and nerves. These are the connections between the brain and the body. 

Often, spine surgery addresses back or neck pain or limited movement. It's an option when these issues don't get better with other treatments. Spine surgery can fix herniated discs, structural spinal problems, tumors, and trauma. It can alleviate pain and restore function.

There are many ways to do spine surgery, depending on the type of surgery and the health issue you need care for. We offer a range of spine surgery options using advanced technologies.

There are different approaches to spine surgery depending on your needs:

• Minimally invasive spine surgery: Uses small incisions and a camera. It avoids cutting large muscles speeding recovery.
• Lateral spine surgery: A less invasive option that reaches the spine from the side.
• Robot-assisted spine surgery: Helps the surgeon place screws and other tools with high precision.
• Open spine surgery: The surgeon makes a larger incision to reach the spine.
• Spinal cord stimulation: Uses a small device implanted near the spine to send electrical signals that help block pain.

Spinal surgery is an option when other treatments haven't worked and your pain gets in the way of your daily activities. Spine surgery isn't the first treatment for most back and neck pain.  

Often, care starts with physical therapy, a back brace, cold and heat therapy, and pain medicine. If you're still having severe pain, you may try shots into the joints or muscles of your spine. These include:

• Pain medicine injections: Often called an epidural. A doctor injects pain medicines like corticosteroids into the space around the spinal nerves. It reduces inflammation and pain, but the effect is temporary.
• Platelet-rich plasma injections: We harvest platelets and plasma from your blood and inject them back into your joints. It can help reduce pain and inflammation.

When these treatments are no longer helping your pain, talk to your doctor about spine surgery.  Spine surgery may be an option if: 

• You've had back or neck pain for a long time
• Physical therapy, medicines, or shots haven't helped
• The pain limits your ability to move, sleep, or work
• You have a spine injury or condition that needs repair

Spine surgery can help you move freely with less pain.

Our team treats many spine and nerve conditions that can cause pain, weakness, or trouble moving. Spine surgery can't fix all types of back problems. We'll work with you to decide if surgery can help in your case. 

Spine injuries and trauma

Injuries from accidents, falls, or strain can damage the bones, discs, or nerves in your spine. We may need to do spine surgery to repair serious damage.  

Spine injuries and trauma that need surgery include: 

• Whiplash
• Fractured vertebrae
• Spinal cord trauma 

Disc and vertebrae problems

The bones and discs in your spine can wear down, move out of place, or press on nerves. Surgery can help relieve back and neck pain and restore movement.

Disk and vertebrae issues that may need surgery include:

• Herniated or bulging discs
• Degenerative disc disease
• Spondylolisthesis, a slipped vertebra
• Spinal stenosis, a narrowed spinal canal

Spinal structural changes

Structural changes to the spine include curves or twists in the spine that can cause pain, poor posture, or nerve problems. Surgery can straighten the spine and prevent future issues. 

Spinal structural changes that may need surgery include:

• Scoliosis, a sideways spinal curve
• Kyphosis, a rounded upper back
• Lordosis, an inward lower back curve

We offer the region's only scoliosis program for kids and adults, including pediatric specialists for growing spines.

Spinal tumors

Tumors in or around the spinal cord or spine can press on the spinal cord or nerves. Surgery removes as much of the tumor as possible. It can ease symptoms and protect your spinal cord.

Nerve-related back pain

When nerves get pinched or damaged, it can cause sharp or shooting pain. Surgery may relieve the pressure and improve function. 

Nerve-related back pain that may need surgery includes:  

• Pinched nerves, for example, sciatica, and radiculopathy
• Compressive neuropathy, which is pressure on the nerves that causes numbness or pain

Bone and joint issues

Conditions that weaken your bones or joints can affect the shape and strength of your spine. Surgery helps stabilize and protect the bones and joints.

Bone and joint issues that may need surgery include:

• Osteoporosis-related fractures
• Osteoarthritis of the spine

There are many types of spine surgery. Your surgeon may operate on the bone, disks, or other parts of the spine. Often, surgeons use multiple types of surgery in a single operation. 

Decompression surgery

When something compresses the nerves in the spine, it can cause pain, numbness, or trouble walking. The surgeon will remove bone or tissue that's pressing on these nerves. This relieves pressure in the spinal canal, restoring movement and function. 

Decompression surgeries include: 

• Laminectomy: Removes part of the vertebra (called the lamina) to create more space for the spinal cord
• Laminoplasty: Expands the spinal canal by creating a hinge in the lamina, mostly used in the neck
• Discectomy: Removes part or all of a damaged disc that's pressing on a nerve

Disc repair and replacement

Spinal discs act as cushions between the bones in your spine. When you damage a disc or it slips out of place, it can press on nerves and cause pain. Surgery can remove or replace the damaged disc. This relieves pressure and restores movement. 

Disk surgeries include:

• Disc removal and repair: Your surgeon trims or removes the damaged part of the disc.
• Total disc replacement: Your surgeon removes the entire disc. They replace it with an artificial one. This helps maintain normal spinal motion.

Spine stabilization and fusion

We use bone grafts and implants to stabilize your spine. A more stable spine reduces pain and helps healing. Injuries, disc damage, or structural changes can all weaken the spine. 

Spinal fusion is one of the most common treatments. It joins 2 or more vertebrae, so they no longer move. This can relieve pain caused by motion in a damaged part of the spine.  

The approach we use depends on your condition and anatomy. We can access the spine from the front, back, or side of your body. 

Types of spinal fusion include: 

• Anterior lumbar interbody fusion (ALIF): Done from the front
• Posterior lumbar interbody fusion (PLIF): Done from the back
• Transforaminal lumbar interbody fusion (TLIF): A back approach that moves nerves less
• Lateral lumbar interbody fusion (LLIF) and oblique lumbar interbody fusion (OLIF): Done from the side 

For spine fractures, other options include vertebroplasty or kyphoplasty. These are less invasive options. The surgeon injects medical cement into the bone to stabilize it. In kyphoplasty, they insert and inflate a balloon to restore the bone's shape before cementing it. 

We also use spinal implants like rods, screws, or plates. These support the spine while it heals. We may use these with other surgeries for added stability. 

Scoliosis surgery

Scoliosis surgery helps straighten and stabilize the spine. It's an option when a spinal curve is severe or worsening. The goal is to reduce pain, improve posture, and protect the spinal cord and nerves. 

Most scoliosis surgeries use spinal fusion to hold the spine in a corrected position. In some cases, your surgeon will also fix kyphosis or other structural spine issues.  

For young children who are still growing, we may use magnetic expansion control (MAGEC) growing rods. The surgeon implants the rods during surgery. After they've healed, we can stretch the rods using a magnetic remote. MAGEC rods help guide the spine's growth without another operation. 

Spine surgery is a major operation. Your care team will walk you through the risks and benefits of your procedure to help you make an informed decision.  

At Carilion, our spine surgeons are board-certified, fellowship-trained neurosurgeons and orthopedic spine experts. 

Both are experts in the back and spine. Both can be experts at performing spine surgery. In some cases, your care team will include both.  

They work with a team of:  

• Nurse practitioners
• Physician assistants
• A dedicated rehabilitation team 

Before surgery, you'll attend Spine School, a pre-surgical educational class.  You'll learn about: 

• What happens before, during, and after surgery
• What to bring and how to care for yourself at home
• How long recovery might take

Your experience with spine surgery will be unique. It will depend on your health history, back, or neck issues and what you hope to accomplish. Preparation and recovery vary significantly from person to person and procedure to procedure. 

After surgery, you may work with our physical therapy team to get moving again. Our rehabilitation team will help you regain strength and independence, one step at a time.  

Risks of spine surgery 

All surgeries have risks. Your doctor will explain them and answer any questions you may have. Risks may include: 

• Infection
• Nerve damage
• Pain that returns
• Spinal fluid leak or headache
• Problems with spinal implants or fusion