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What a neurosurgeon wants you to know about back surgery

The prospect of having back surgery can be nerve-wracking, but knowing what to expect, from your first doctor’s visit through the removal of your final stitch, may ease that worry.

We spoke with Sabino D’Agostino, DO, a neurosurgeon with Trident Medical Center in Charleston, South Carolina, to get the details on a variety of back surgeries, as well as tips for preparation and recovery.

Who really needs spine surgery?

Back pain caused by overexertion, poor posture or wearing high heels often goes away by itself, but nonsurgical treatments like physical therapy, pain medication and steroid injections to help reduce inflammation may speed it along. In these cases, when pain is caused by muscle or ligament strain, surgery won’t likely be necessary.

But, when back pain is caused by a deeper issue, like disk herniation or spinal nerve compression, surgery may be an option if your pain doesn’t subside with the help of other treatments. It is usually performed to address spinal weakness or instability, nerve pressure, spinal deformity or bone or joint malformation caused by conditions like arthritis.

If you experience back pain and have been diagnosed with one of these conditions, speak with your doctor about whether surgery is right for you.

Traditional Surgery vs. Minimally Invasive Surgery

You and your provider will make a number of decisions about your procedure, one of which is choosing between an open surgery and a minimally invasive one.

Traditional open surgeries involve incisions about five or six inches long, which may cause nearby muscle and tissue damage and require long recovery periods. Minimally invasive spine surgery, on the other hand, uses smaller incisions and specialized instruments that generally cause less damage.

Other potential benefits of less invasive procedures include:

  • Better cosmetic results
  • Less risk of blood loss
  • Reduced risk of infection
  • Lower likelihood of dependence on pain medication
  • Shorter hospital stay
  • Less trauma to organs

Common Types of Spine Surgery

The type of procedure you have will ultimately depend on your specific back issue. Common surgeries include:

  • Laminectomy
  • Foraminotomy
  • Diskectomy
  • Disk replacement
  • Spinal fusion

Preparing for Your Surgery

You can take steps to prepare your body for spine surgery. Prior to the operation, you will likely be evaluated by your primary care physician and any doctor you see on a regular basis, like a cardiologist.

Certain medications, like ibuprofen or aspirin, can affect surgery, so speak with your doctor about any prescription and over-the-counter drugs you take. Getting enough sleep, exercising regularly and eating a healthy, varied diet are all important prior to surgery.

There are still risks

Even the smallest procedures have some risks, including the possibility of infection, blood loss and adverse reactions to anesthesia.

Additionally, although spine surgery can be an effective way to treat back pain in certain situations, there is a possibility future procedures will be necessary. Degenerative disk disease is a continuous process, D’Agostino reminds us. “When we operate on the back or the spine, we operate on one part of it,” he says. “Although we fix one part of the spine, there could be continued degeneration in other parts.”


Everybody is different, and every procedure comes with a different recovery period, but most people bounce back quickly after less invasive spine surgeries. The average hospital stay following these procedures is one to two days. Since small incisions disrupt less muscle and tissue, patients typically experience less postoperative pain, and minor discomfort can be managed with medication and the help of your doctor.

Your doctor may also recommend physical therapy to help strengthen the muscles around the spine. Regardless of the procedure, D’Agostino says patients should expect to attend follow-up appointments, during which your provider will assess your progress and let you know when it’s safe to resume normal activities.



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