New York Spine Institute Spine Services

Types of Neurosurgery Procedures for Chronic Back and Neck Pain

Types of Neurosurgery Procedures for Chronic Back and Neck Pain

By: Nicholas Post, M.D. FAANS

Nicholas Post, M.D. FAANS, a board-certified neurosurgeon has joined the NY Spine Institute medical staff. NYSI is now the only private practice on Long Island to offer true comprehensive spinal care spanning spine-specific and general orthopedics, neurosurgery, physical therapy, and pain management subspecialties for patients with acute, chronic, or debilitating orthopedic or complex spine and brain conditions.

Back and neck pain can severely limit your range of motion, making daily activities like work and exercise far more taxing than they should be. If you’re dealing with ongoing back or neck pain that won’t subside with home remedies and natural treatments, surgery may be a practical next step to consider.

You may also wonder if you should see an orthopedic doctor or neurosurgeon for back pain. Neurosurgeons specialize in more complex causes of cervical (neck) and lumbar (lower back) pain, and they have more spinal surgery training than any other medical specialty. They are the only specialty that treats the entire spine. Their extensive training qualifies them for nonsurgical treatments, as well.

Learn about the different surgeries neurosurgeons use to relieve back and neck pain.

Causes of Neck and Back Pain

Back and neck pain can range from mild aches to extreme and even disabling pain. Many factors can contribute to this chronic pain and discomfort, including:

  • Repeated strenuous activity, such as bending down and lifting heavy loads.
  • Abnormal growths like tumors or bony overgrowths (bone spurs).
  • Excess body weight putting pressure on the spine and discs.
  • Infection.
  • Sprain or strain.
  • Ligament or muscle tears.
  • Herniated discs and pinched nerves.
  • Congenital abnormalities in the bones and vertebrae.
  • Joint problems like arthritis.
  • Muscle spasms or tension.
  • Osteoporosis and spinal compression fractures.
  • Smoking.

What Does a Neurosurgeon Do for Back Pain?

Below are some common surgical procedures for chronic back pain:

1. Spinal Fusion

Spinal fusion surgery removes the spinal disc between two or more vertebrae and then places bone or a bone-like material in the empty space. The surgeon might use metal rods, plates or screws to hold the bones together. This process allows the bones to connect and heal as one.

Fusing the vertebrae hinders movement between them, which can prevent pain. However, spinal fusion may reduce flexibility in the spine, as it restricts motion in your vertebrae. Ample recovery time is also necessary for the bone grafts to grow and fuse the vertebrae. It usually takes at least three to four months for the bones to heal after fusion with laminectomy, and full recovery can take up to a year.

Spinal fusion is a standard procedure for:

  • Reshaping the spine. Spinal fusion can resolve problems with spine formation. One example is scoliosis, which occurs when the spine curves sideways.
  • Correcting spinal instability or weakness. Excess movement between the vertebrae can make the spine unstable. This is a common side effect of severe spine arthritis. Spinal fusion can help restore stability in the spine. Additionally, a neurosurgeon may use spinal fusion to stabilize the spine following the removal of a damaged disc.

2. Laminectomy

A laminectomy procedure removes part of a bone, ligament or bone spur in your back. This process enlarges the spinal canal and reduces pressure on the spinal nerves to alleviate pain, numbness or weakness. This pressure is often caused by bone spurs in the spinal canal, which are common in people with spinal arthritis.

Laminectomy is also the standard surgery for lumbar spinal stenosis, the narrowing of the spinal canal. However, the procedure can sometimes decrease stability in the spine. In this case, a spinal fusion may accompany the laminectomy.

3. Discectomy

A neurosurgeon usually performs this procedure when a disc slips out of place, presses on a spinal nerve and causes back pain. A discectomy removes all or part of a disc.

This process might involve a large incision in your back or a less invasive procedure called a microdiscectomy. A microdiscectomy uses small incisions and a tiny video camera or microscope to view the procedure. This is a typical surgery for lumbar disc herniation.

Discectomies are often performed with other surgeries like laminectomies, foraminotomies and spinal fusions. In addition to lumbar discectomies, neurosurgeons can perform cervical discectomies to relieve neck pain.

4. Kyphoplasty and Vertebroplasty

These procedures inject a cement-like material into the vertebrae, which hardens and strengthens the bone. They are typically used to repair compression fractures caused by osteoporosis.

5. Foraminotomy

During this procedure, a neurosurgeon cuts away bone from the sides of the vertebrae, enlarging the space where nerve roots exit the spinal canal (the neural foramen). This extra room can ease pressure on the nerves.

This procedure is often used to reduce back pain associated with a compressed spinal nerve. Like a laminectomy, a foraminotomy can make the spine less stable, so a spinal fusion may also be necessary.

What Does a Neurosurgeon Do for Neck Pain?

Here are some typical procedures to alleviate neck pain:

1. Artificial Disc Replacement

An artificial disc replacement can be used to repair a pinched nerve in the neck. The surgeon first makes an incision in the front of the neck, removes the disc that is putting pressure on the nerve, then places a synthetic implant into the empty space. This implant can be metal or a combination of metal and plastic.

This procedure helps restore range of motion and flexibility in the neck. However, it isn’t recommended for people with conditions like osteoporosis, cancer, rheumatoid arthritis and severe neck arthritis.

2. Cervical Spinal Fusion

Neurosurgeons can perform cervical spinal fusions in addition to lumbar spinal fusions. A cervical spinal fusion joins two or more vertebrae in the neck to boost stability. A surgeon may perform this procedure for a severe cervical fracture, a compressed spinal cord or a pinched nerve.

3. Laminectomy

A laminectomy can also occur in the neck. During this procedure, a surgeon makes an incision at the back of the neck and removes the lamina, the roof of the spinal canal that supports the backside of the spinal cord. They’ll also remove any bone spurs, discs or ligaments causing compression and neck pain. A spinal fusion may also be performed for added stability.

4. Laminoplasty

Like a laminectomy, a laminoplasty makes an incision on the back of the neck. However, the surgeon creates a door-like hinge rather than removing the lamina. This hinge helps open the lamina to relieve pressure on the spinal cord and nerves. The surgeon may also insert metal implants to prevent the hinge from coming loose.

5. Posterior Cervical Foraminotomy

During a posterior cervical foraminotomy, a surgeon makes an incision in the back of the neck, uses a special tool to remove part of the lamina, then removes any additional tissue or bone pressing on the impacted nerve. This is another go-to procedure for treating a pinched nerve in the neck.

In some cases, this procedure can treat symptoms without removing a disc (discectomy). This can expedite recovery, as it’s less invasive and doesn’t require a spinal fusion.

When to See a Neurosurgeon for Back or Neck Pain

If severe back or neck pain persists after several weeks of nonsurgical treatments — such as physical therapy, chiropractic therapy, acupuncture or medication — it may be time to meet with a neurosurgeon about surgical treatment. If you’re seeking back or neck surgery in New York, visit New York Spine Institute to consult with a specialist in our neurosurgery division.

Why Trust Us for Neurosurgery Services?

We are one of the largest multispecialty orthopedic and spine centers in the Tri-State. We’re passionate about delivering the highest level of personalized care to every patient who books with us. New York Spine Institute treats a variety of complex conditions, including spinal tumors, herniated discs, spinal instability, pinched nerves and more.

Restoring the quality of life you desire is our top priority. Read through some of our patient testimonials to get a sense of the quality of care that goes into our services.

Book Your Appointment With New York Spine Institute Today

Whether you need a cervical or lumbar discectomy, a spinal fusion or a laminectomy, our skilled team of neurosurgeons can work with you to address the issue and determine the appropriate treatment route. Find one of our office locations near you, then get in touch with us today to schedule your consultation appointment.