What Percentage of Back Surgeries are Successful?
Surgery may be used to treat a wide variety of back conditions, including degenerative disc disease, scoliosis, and spinal stenosis, when conservative treatments fail. Though all surgical procedures carry risk, including blood clotting, nerve injury infection, or persistent pain, in many instances, surgery has proven to be more effective at relieving pain and improving physical function and quality of life as compared to conservative treatment. [1-5] The following article outlines success rates for the most common types of back surgery.
Spinal Fusion
Spinal fusion may relieve symptoms of degenerative disc disease, scoliosis, spinal stenosis and several other conditions by immobilizing the joint between two vertebrae. [6-9] Recovery will take several months, with complete spinal fusion—the point at which you are completely unrestricted—requiring about 12 months. [10,11]
Generally, spinal fusion surgery provides significant improvement in short- and long-term pain and quality of life, even in individuals older than 75 years old, though they may have higher complication rates. [12-14]
Approximately 90% of spinal fusions are successful, with a 71.1% satisfaction rate. [14-16] 3.9% of spinal fusions require reoperation, and mortality rates are extremely low, with complex and simple fusions having .321% and .105% mortality rates respectively. [14,17]
Spinal Decompression
Spinal decompression surgery involves the removal of bone and soft tissue around a bulging disc to reduce pressure on the spinal cord and/or nerve roots. This may include facetectomy, foraminotomy, laminectomy, laminotomy, discectomy, or corpectomy. [7,8]
Patients normally require 4-6 weeks of recovery before returning to work and resuming strenuous activities but success rates are high, estimated between 71 and 90%. [18,19] Spinal decompression has been associated with short- and long-term improvements in leg pain, back pain, and disability. [20,21]
Vertebroplasty
Vertebroplasty is a minimally invasive procedure where cement is injected into collapsed vertebrae to repair compression fractures often caused by osteoporosis. [22,23] Spinal compression fractures are common, especially among older women, and are generally treated with rest, oral analgesics, muscle relaxants, bracing, and physical therapy. [22,24] However, if conservative measures are unsuccessful at relieving pain, vertebroplasty is performed to strengthen the fracture.
Vertebroplasties have a high success rate, reported between 73% and 90%, and relieve pain both short- and long-term. [25,26] Surgical complications occur in 1-3% when treating osteoporotic fractures, and in 7-10% of procedures to treat malignant neoplasms. [25]
Artificial Disc Replacement
Disc replacement involves replacing the diseased vertebral disc with an artificial disc to restore function of the spine and eliminate back pain. Disc replacement surgery has exceptionally good outcomes, between 85% and 95%, and satisfaction rates between 75.5% and 93.3%. [27,28]
In addition to significant reductions in pain and disability, artificial disc replacement may reduce the likelihood of future degeneration of adjacent discs. [27-29] Though all surgery comes with risks, the most common back surgeries have high success rates and relatively low complication rates.
Speak with your physician about the risks, benefits, and expected recovery process of surgery to make an informed decision about your treatment plan.
Sources
1. Montgomery S. TLIF Back Surgery Success Rates and Risks Spine Health https://www.spinehealth.com/treatment/spinal-fusion/tlif-back-surgery-success-rates-and-risks
2. Risks: Lumbar decompression surgery United Kingdom National Health Service https://www.nhs.uk/conditions/lumbar-decompression-surgery/risks/
3. Rodriguez M. Laminectomy and Spinal Stenosis: Risks and Complications Spine Health https://www.spine-health.com/treatment/back-surgery/laminectomy-and-spinal-stenosis-risks-andcomplications
4. Spine Surgery: When it works and when it doesnt Ortho Bethesda https://www.orthobethesda.com/blog/spine-surgery-when-it-works-and-when-it-doesnt/
5. Chen BL, Guo JB, Zhang HW, et al. Surgical versus non-operative treatment for lumbar disc herniation: a systematic review and meta-analysis. Clin Rehabil. Feb 2018;32(2):146-160. doi:10.1177/0269215517719952
6. Spinal Fusion AAOS. https://orthoinfo.aaos.org/en/treatment/spinal-fusion/
7. Surgical Options for Degenerative Disc Disease (DDD). Boston Scientific Corporation https://www.painscale.com/article/surgical-options-for-degenerative-disc-diseaseddd#:~:text=Three%20main%20types%20of%20surgery,replacement%20(intervertebral%20disc%20arthroplasty)
8. Wu PH, Kim HS, Jang I-T. Intervertebral Disc Diseases PART 2: A Review of the Current Diagnostic and Treatment Strategies for Intervertebral Disc Disease. Int J Mol Sci.2020;21(6):2135. doi:10.3390/ijms21062135
9. Surgery HSHfS. Minimally Invasive Lower Back Surgery for Disc Degeneration: The AnteroLateral (Side) Approach: a new minimally invasive surgical approach to lumbar spine fusion. HSS https://www.hss.edu/CONDITIONS_MINIMALLY-INVASIVE-LOWER-BACK-SURGERYANTEROLATERAL.ASP
10. Surgical Treatment for Scoliosis. AAOS https://orthoinfo.aaos.org/en/treatment/surgicaltreatment-for-scoliosis
11. Spinal Fusion Surgery for Scoliosis UCSF Health https://www.ucsfhealth.org/treatments/spinalfusion-surgery-for-scoliosis
12. Costa F, Ortolina A, Tomei M, Cardia A, Zekay E, Fornari M. Instrumented fusion surgery in elderly patients (over 75 years old): clinical and radiological results in a series of 53 patients. Eur Spine J. 2013;22 Suppl 6(Suppl 6):S910-S913. doi:10.1007/s00586-013-3021-0
13. Epstein NE. Spine surgery in geriatric patients: Sometimes unnecessary, too much, or too little. Surg Neurol Int. 2011;2:188-188. doi:10.4103/2152-7806.91408
14. Perez-Cruet MJ, Hussain NS, White GZ, et al. Quality-of-life outcomes with minimally invasive transforaminal lumbar interbody fusion based on long-term analysis of 304 consecutive patients. Spine. 2014;39(3):E191-E198. doi:10.1097/BRS.0000000000000078
15. Phillips FM, Slosar PJ, Youssef JA, Andersson G, Papatheofanis F. Lumbar spine fusion for chronic low back pain due to degenerative disc disease: a systematic review. Spine (Phila Pa 1976). Apr 1 2013;38(7):E409-22. doi:10.1097/BRS.0b013e3182877f11
16. Dohrmann GJ, Mansour N. Long-Term Results of Various Operations for Lumbar Disc Herniation: Analysis of over 39,000 Patients. Medical Principles and Practice. 2015;24(3):285-290. doi:10.1159/000375499
17. Poorman GW, Moon JY, Wang C, et al. Rates of Mortality in Lumbar Spine Surgery and Factors Associated With Its Occurrence Over a 10-Year Period: A Study of 803,949 Patients in the Nationwide Inpatient Sample. Int J Spine Surg. 2018;12(5):617-623. doi:10.14444/5076
18. Overview: Lumbar Decompression Surgery UK National Health Service https://www.nhs.uk/conditions/lumbar-decompression-surgery/
19. Spinal Decompression Therapy. Oregon Spine and Disc https://oregonspineanddisc.com/spinaldecompression.php
20. Sunderland G, Foster M, Dheerendra S, Pillay R. Patient-Reported Outcomes Following Lumbar Decompression Surgery: A Review of 2699 Cases. Global Spine J. Mar 2021;11(2):172-179. doi:10.1177/2192568219896541
21. Anjarwalla NK, Brown LC, McGregor AH. The outcome of spinal decompression surgery 5 years on. Eur Spine J. 2007;16(11):1842-1847. doi:10.1007/s00586-007-0393-z
22. Back Surgery American Society of Anesthesiologists https://www.asahq.org/madeforthismoment/preparing-for-surgery/procedures/back-surgery/
23. Vertebroplasty. Johns Hopkins Medicine https://www.hopkinsmedicine.org/health/treatmenttests-and-therapies/vertebroplasty
24. Compression Fractures Cleveland Clinic https://my.clevelandclinic.org/health/diseases/21950- compression-fractures
25. Predey TA, Sewall LE, Smith SJ. Percutaneous vertebroplasty: new treatment for vertebral compression fractures. Am Fam Physician. Aug 15 2002;66(4):611-5.
26. Kotwica Z, Saracen A. Early and long-term outcomes of vertebroplasty for single osteoporotic fractures. Neurol Neurochir Pol. Sep-Oct 2011;45(5):431-5. doi:10.1016/s0028-3843(14)60310-8
27. Cui X-D, Li H-T, Zhang W, Zhang L-L, Luo Z-P, Yang H-L. Mid- to long-term results of total disc replacement for lumbar degenerative disc disease: a systematic review. Journal of Orthopaedic Surgery and Research. 2018/12/26 2018;13(1):326. doi:10.1186/s13018-018-1032-6
28. Disc Replacement Surgery Success Rates Minimally Invasive Neurosurgery Texas https://minimallyinvasiveneurosurgerytexas.com/disc-replacement-surgery-success-rates/
29. Volpe KD. Cervical Artificial Disc Replacement Outcomes at 5 to 10 Years Spine Universe https://pro.spineuniverse.com/news/cervical-artificial-disc-replacement-outcomes-5-10-years
