In this leaflet we have tried to give you an idea of the aim of
surgery for back pain and some of the risks and benefits. It
is important to stress that there are many differences
between one person and another in how they get symptoms.
We hope that this information will help you to decide what
particular questions you would like to ask when you meet
with your surgeon.
C o n ta c t
D e ta i l s
Spinal Team
Nuffield Orthopaedic Centre
Windmill Road
Headington
Oxford
OX3 7LD
Phone:
Fax:
01865 738051
01865 738027
Web Site
www.noc.nhs.uk
Surgery for LBP version 1
© 2005 Nuffield Orthopaedic Centre
Spinal Improvement Group Dec 2005
Surgery for
Low Back Pain
This leaflet aims to give you some information about low
After discharge from hospital
back pain and why surgery may be helpful to you. It will
Your physiotherapist will tell you how to exercise before
help you make your mind up whether surgery is what you
you go home. You should gradually increase your activi-
want.
ties over time. The spine is quite stable and it is not possible to dislodge the spine of the metal implants. You are
Why have I got Low Back Pain?
unlikely to require formal physiotherapy initially. You
Back pain is very common in the general population to
will be reassessed at 6 – 8 weeks in the clinic by the medi-
such an extent that around 70% of people will seek advice
cal team, and the need for any further treatment decided
from a health professional for back pain, at some time in
then. You will be followed for 1 – 2 years after the opera-
their life. As we mature everyone develops aging changes
tion. X-Rays are usually used to monitor progress.
in the spine, yet not every one gets back pain. Sometimes
the aging changes are more obvious at one level of the
Driving earlier than 4 to 6 weeks is probably not a good
back and cause a lot of pain. Most people however have
idea (as much for other peoples benefit as your own). The
not done anything wrong and still get back pain. As yet
time you will require off work is very variable depending
we do not fully understand why. Despite the pain, your
on your occupation, but it might be as little as 4 weeks or
spine is still one of the strongest parts of the body. It is
as much as 3 months.
made up of many bony blocks joined by discs to give it
strength and flexibility
What will happen if I do not have an operation?
What can I do to help the pain?
Some people do not want to have an operation. The pain
•
for many of these people remains much the same for many
commonly people have a combination of a strong
years and may improve, as they get older. In some the
painkiller and an anti-inflammatory. Some people have a
pain may improve over a few years. However a small
lot of muscle spasm in their back and therefore use an
number get a lot worse and then opt to consider an
antidepressant, which has a muscle relaxing effect.
Painkillers have a key part in managing the pain. Most
operation later on.
•
It is also recommended that you remain active rather
Surgical Technique
than rest for long periods. Obviously this is difficult when
Fusion is the commonest. This has been used for many
your pain is so bad. Many people find that it is best to do
decades, and works in most cases. The operation can be
what you can and then take a short break for around 15
carried out from the back, the front or both front and back.
minutes. Then get up and do a bit more. Although the
Usually a bone graft is needed and this is taken from a part
pain is severe being active will not do any damage.
of the pelvis where the extra bone is not needed. Metal
implants are often used to enhance the fusion.
•
Short-term relief can also be achieved by things like,
heat, ice, relaxation techniques, acupuncture or TENS ma-
Hospital treatment
chines. Although none of these cure the pain they may
The time in hospital is somewhat variable but is usually
help you cope better.
4 – 7 days. It could be longer or shorter. Once your
wound is healing well and you are reasonably independent
you will be allowed home.
When am I best to have an operation?
What are the risks of surgery?
If you have had severe back pain for a long time and it is
This is major surgery. Less than 5 people out of 100
not responding to other treatments then surgery could be
having surgery for back pain will be worse after the
considered. You should have tried at least some of these
operation. Some of these risks are mentioned below:
treatments before considering surgery:
•
Nerve damage, which can lead to pain, weakness or
•
Pain killers
numbness in the legs.
•
Physiotherapy
•
•
Chiropractic/ Osteopathy
damaged.
•
Rehabilitation programmes
•
•
Injections
but varies by the type of operation done.
•
Pain Relief Unit
•
The back pain can be made worse after the operation.
•
If a fusion operation is carried out, sometimes the bone
Rarely the nerves to the bowel and bladder can be
Infection occurs in less than 5 out of 100 operations,
Why would an operation help?
does not heal and this may require another operation.
The aim of surgery for back pain is to reduce the severity
•
of the pain in the long term. The success rate is variable
metal implant is used, this may need to be removed, for
to some extent depending on exactly what the problem is
example for infection.
with the spine. About 70% of people will have useful pain
•
relief with this type of surgery. However, the surgery is
Sometimes the lining around the nerves can be damaged
not likely to cure all your pain.
(the dura) but this does not usually lead to long-term
Sometimes another operation is necessary and if a
Excessive bleeding can occur.
problems.