There are many questions to consider before pursuing spine surgery. Is surgery necessary to treat the issue or would a non-surgical method be more appropriate? If surgery is required, is it better to have traditional spine surgery or minimally invasive spine surgery? What is minimally invasive spine surgery and how does it differ from traditional spine surgery? When someone comes to us with extremity symptoms, we almost always suggest they first get an evaluation with their primary care physician. If a person is experiencing low back pain or neck pain, we will usually watch them over time and encourage them to maintain good, stable physical activity to see if the issue resolves. If the issue is not resolving with physical activity, over the counter treatments, or pain management and anti-inflammatory medication, the next step would be to see a doctor for an evaluation. We implement leading surgical techniques and technology as appropriate, and our patients benefit from our surgeons’ academic research to further both minimally invasive and complex spine surgery procedures. Spinal fusion: This is the most common surgery for chronic nonspecific back pain with degenerative changes. The doctor will join spinal bones, called vertebrae, together. This limits the motion between them and how far your nerves can stretch. But it probably won’t limit your activity. It’s rare, but the bones don’t always fuse completely. Smoking can make this complication more likely. If it happens, you may need another operation to fix it. Laminectomy: This is the most common surgery for lumbar spinal stenosis. In this procedure, a surgeon removes parts of the bone, bone spurs, or ligaments in your back. This relieves pressure on spinal nerves and can ease pain or weakness, but the procedure can make your spine less stable. If that happens, you’ll probably need a spinal fusion as well. Doctors sometimes do the two procedures together. Foraminotomy: This surgery is used to relieve pain associated with a compressed nerve in the spine. The surgeon cuts away bone at the sides of your vertebrae to widen the space where nerves exit your spine. The extra room may relieve pressure on the nerves and ease your pain. Like a laminectomy, this procedure can also make your spine less stable. So the surgeon may do a spinal fusion at the same time. That’ll increase the amount of time you need for recovery. Diskectomy: Sometimes a disk, the cushion that separates your vertebrae, can slip out of place, press on a spinal nerve, and cause back pain. In a diskectomy, the surgeon removes all or part of the disk. They may have to make a big cut in your back, or they may be able to do it through a small one called microdiscectomy. Microdiscectomy is performed with an operating microscope through a smaller incision than open discectomy and has become the standard surgical procedure for lumbar disc herniation. Sometimes a diskectomy is part of a larger surgery that includes laminectomy, foraminotomy, or spinal fusion. Disk replacement: A surgeon removes the damaged spinal disk and inserts an artificial one between your vertebrae. Unlike fusion, this lets you continue to move your spine. Recovery time may be shorter than for a spinal fusion, too. But there is a slight chance the new disk could slip or fall out of place and require repair. Interlaminar implant: This is a minimally invasive alternative to more invasive laminectomy or laminectomy plus fusion surgery. The surgeon implants a U-shaped device between two vertebrae in your lower back. It helps keep the space between them open and eases pressure on your spinal nerves. It can be done at the same time as a laminectomy. Unlike spinal fusion, the implant provides stability and lets you move your back almost like normal. You may not be able to bend backward as easily in that area. The biggest risk of back surgery: Not knowing for sure if it’s going to help with your pain. The best thing you can do is talk openly with your surgeon so they know what’s going on with your health and you know what to expect before you go into the operating room. The scholar journal uses editorial manager system for maintaining quality of the whole process of manuscript submission, peer review and tracking. Journal of Surgery and Anesthesia aims to maintain a rapid editorial procedure and a rigorous peer-review system for all the submitted manuscripts. The submitted articles are peer-reviewed within 21 days of submission and the accepted articles are published immediately. Acceptance of any manuscript for publication requires approval of at least two independent reviewers and the editor. Submit manuscripts as an e-mail attachment to manuscripts@longdom.org