Back & Spine

Back and Spine Treatments

Back pain is the largest single cause of disability in the UK. While some conditions require surgery, others can be treated with injections, manipulative therapy, and physiotherapy. This page explains more about our treatments for the back and spine, so you’ll understand what to expect.

• Steroid injections
• Decompression
• Discectomy
• Cervical laminectomy
• Lumbar nerve root decompression

Common conditions

Some back and spine conditions come with age, while injury can cause others. Common conditions include pulled muscles, slipped discs, and trapped nerves, as well as ankylosing spondylitis, spinal nerve root inflammation, fracture, or wear and tear.

Some conditions compressing nerves, such as degenerative spondylolisthesis and lumbar disc protrusion, can be helped with physiotherapy, medication, lifestyle changes, and manipulative therapy. However, if you and your surgeon agree that treatment isn’t working, surgery is an option.

For other conditions like spinal stenosis, surgery is a must as the pressure needs to be taken off the nerves. Patients with compressed nerves often experience lower back pain, leg pain, stiffness, numbness, pins and needles and muscle tenderness.

Back and spine conditions can often be treated and managed through injections, physiotherapy, and surgery, helping you maintain your quality of life and return to activities.

Popular treatments

Whether you’re looking for surgery or non-invasive options, we offer a range of treatments for conditions affecting the back and spine.

• Steroid injections for treating inflammation and pain in the joint and soft tissues
• Decompression for spinal stenosis
• Discectomy for a lumbar disc protrusion, resulting in nerve root compression (trapped nerve) and leg pain (sciatica)
• Cervical laminectomy to decompress the spinal cord and bony spurs
• Lumbar nerve root decompression for foraminal stenosis

Microdiscectomy, discectomy, and spinal decompression surgery are some of our most common spine and back surgeries.  

Microdiscectomy is a minimally invasive surgical procedure to remove a portion of a herniated disk that’s pressing on a nerve. Using a small incision and microscope, the surgeon relieves nerve compression. This reduces pain and improves function.

A discectomy removes part or all of an intervertebral disc. A discectomy can be performed in open surgery or using minimally invasive methods. The goal is to reduce pressure on spinal nerves or the spinal cord, but it can also remove the disc material.

Lumbar decompression and stabilisation are performed under general anaesthetic. The surgeon makes an incision in the midline of the back and lifts the muscles from the bony arch. The surgeon clips the bone and the facet joints to remove pressure on the nerves. The surgeon assesses the spine's stability and considers a bone graft or a spinal fusion.

Preparation

Whether you’re having a decompression or a discectomy, the preparation for spine and back surgery remains the same.

Firstly, you should optimise your health to aid your recovery. This could mean addressing your diet and, if you smoke, quitting. Ahead of the surgery, read about the operation from reputable sources, give your consent, and ask the doctor or surgeon to clarify any questions or concerns you have.

You’ll need to tell the consultant if you’re undergoing treatment for any conditions (even if it’s unrelated) and if you’re pregnant. If you have new pain or symptoms, such as bladder or bowel incontinence, you should tell us. We may need to arrange an urgent valuation, scans, emergency surgery, or postpone the operation.

At your pre-assessment visit, you’ll receive further advice on preparing for your surgery and ask any questions. You may also be asked to change lifestyle habits that could impact your condition, treatment and recovery, such as exercise, diet and smoking.

Risks and complications

As with all surgeries, back and spine surgery has risks and, in some cases, may lead to complications. You should always discuss the specific risks with your surgeon.

The risks can include:

• Damage to the nerve root and the outer lining or covering surrounding the nerve roots happens in less than 5% of cases. It’s caused by the bone being stuck to the lining and tearing as it’s lifted. A stitch or patch repairs the hole or tear in the nerve root. This complication could result in leg or back pain, weakness or numbness, leaking from the wound, headaches, or, very rarely, meningitis.
• Recurrent leg pain.
• Problems with positioning during the operation might include pressure problems, skin and nerve injuries, and eye complications. We use a special gel mattress and protection to help minimise this risk.
• Superficial wound infections may occur in 2-4% of cases. These are often easily treated with a course of antibiotics. Deep wound infections may occur in less than 1% of cases. Sometimes, these require further surgery to clear the infected tissues. The risk may be higher for people with diabetes, reduced immune systems, or those who are taking steroids.
• Blood clots in the deep veins of the legs or lungs can occur. This happens when the blood in the large vein of the leg forms blood clots and causes the leg to swell and become warm. Left untreated, it can be fatal as the clot may travel and cut off the blood supply of the lungs. Reduce the risk of blood clots by moving soon after your operation, walking when you can, performing the ‘preventing blood clots’ exercises and keeping well hydrated. The advice is to stop taking contraceptives containing oestrogen four weeks before surgery, as it can increase the chances of developing a blood clot.
• Difficulty with screw placement causing injury to the nerves or a screw breakage (Lumbar decompression and stabilisation).
• If you’re using blood thinners, you should tell the consultant, as they can increase the risk of bleeding.
• Bone graft non-union or lack of solid fusion can happen in less than 5% of cases. Follow advice on how to prevent this condition (Lumbar decompression and stabilisation)
• Worse symptoms: There are very rare but serious complications that might include damage to the cauda equina and paralysis. This can happen if there is bleeding into the spinal canal after surgery. If bleeding happens, you may need further surgery. Paralysis can occur due to damage or reduction in the blood supply of nerves or the spinal cord. Stroke, heart attack or other medical anaesthetic problems, including death happen in 1 out of 250,000 cases under general anaesthetic.

If you’re having a fusion procedure, be aware of factors that can negatively impact a solid fusion and cause complications. These include:

• Smoking
• Diabetes or chronic illness
• Obesity
• Malnutrition
• Osteoporosis
• Post-surgery activities and long-term (chronic) steroid use

Recovering from Back and Spine Treatments

Recovery times vary, but initial pain and swelling improve within a few weeks. Full recovery might take several months. Recovery involves immediate post-treatment care, such as managing pain and swelling, followed by a rehabilitation phase that includes a gradual increase in activity. Assistive devices like scooters or compression stockings can aid mobility and recovery. Use them as your provider recommends to support your healing process and improve comfort.  Long-term care includes maintaining lifestyle changes and attending follow-up visits. Seek medical attention if you notice any concerning symptoms.