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Lower back surgery may be performed to treat spinal instability, back pain, and impaired bowel weakness in the legs if conservative treatments do not alleviate symptoms. Dr. Andrew K. Simpson provides personalized nonsurgical and surgical treatment for a wide range of spine conditions in Chestnut Hill, Boston, and Foxborough, MA. He also provides specialized aftercare for patients. Contact Dr. Simpson for an appointment today.

Disease Overview

Lower back pain is one of the most common health problems experienced by most individuals, at different phases of their lives. 

The most common causes of low back pain include:

  • Lumbar spinal stenosis
  • Herniated disc
  • Adult degenerative spondylolisthesis
  • Degenerative disc disease

Indications of Lower Back Surgery

Low back pain usually does not require surgery. However, surgery may be beneficial for persistent pain, spinal instability, weakness or numbness in the legs or feet, and impaired bowel or bladder function. Lumbar spine surgery may also be considered if all conservative methods have failed to provide pain relief. 

Types of Lower Back Surgery 

Open surgery or minimally invasive technique may be indicated to relieve nerve compression and stabilize the lumbar spine. Your surgeon may choose a minimally invasive approach rather than open spine surgery, due to the lower incidence of complications with minimally invasive surgery.
There are several types of lumbar spine surgeries. If you require surgery, your doctor will decide on the most appropriate type of surgery, based on your condition. Some of the different lumbar surgeries include:

  • Anterior or posterior lumbar interbody fusion (ALIF or PLIF) 
  • Direct lateral lumbar interbody fusion (DLIF)
  • Axial lumbar interbody fusion (ALIF)
  • Intradiscal electrothermoplasty (IDET)
  • Transforaminal lumbar interbody fusion (TLIF)
  • Image-guided spine surgery
  • Laminoplasty
  • Laminotomy

Before Lower Back Surgery 

Before lower back surgery, your doctor will explain the surgical procedure as well as its risks and complications to you. You should obtain a medical clearance from your physician before proceeding with the surgery. Your doctor may also order a few blood tests, X-rays or other imaging tests to assess your medical condition.

Lower Back Surgery Procedure

Spinal fusion with instrumentation has been used to treat many painful conditions of the lumbar spine. In spinal fusion surgery, two or more vertebrae are joined together with the help of bone grafts to eliminate movement between them. Spinal instrumentation is used to stabilize the spine, after the fusion, with the help of implants such as rods, plates, screws and interbody devices. 

After Lower Back Surgery

After lower back surgery, you will be shifted to the recovery room where your vital signs will be closely monitored by the medical staff. You may have mild discomfort following the surgery. 

Postoperative Care following Lower Back Surgery

You should keep your incision area clean and dry. Do not smoke, drive, lift heavy things, swim or use a hot tub. Start physical therapy as directed by your doctor. Take medications as recommended by your doctor as well as arrange a follow-up appointment with your doctor. 

Risks and Complications of Lower Back Surgery

  • The possible risks associated with lumbar spine surgery may include infection, bleeding, problems with anesthesia, and nerve or spinal cord injury.
  • Call your doctor if you experience a fever over 101° F or if the incision site shows signs of infection such as pain, redness, swelling, or alteration in the quantity or smell of the drainage. Also, contact your doctor if you have trouble with bowel or bladder function or numbness over the genital area.
  • Harward Medical School - Andrew K. Simpson, M.D. MBA, MHS
  • Yale University
  • Harward Medical School - Andrew K. Simpson, M.D. MBA, MHS