Making the decision to undergo spinal surgery for back pain or any other spinal condition is not an easy one to make. Many will explore non-surgical options and find relief but others will pursue the same path to no relief. Every case and every patient is different.

Don’t wait until the pain becomes too much to start asking questions. Dean Karahalios, MD, Neurosurgery at NorthShore, answers some common questions concerning back pain and surgery:

How bad does back pain/discomfort have to get to be considered a good candidate for surgery?
Everyone responds to pain in different ways. Only you can judge how bad pain is or how much you can cope with on a day-to-day basis. If you have tried all non-surgical treatments—physical therapy, injections—to no avail, it might be time to consider surgery. And I would say that if it starts to affect your day-to-day routine or prevents you from doing the things you like to do recreationally, surgical treatment might be a good option. There are minimally invasive options for many conditions. 

Is there a difference in treatment if surgery is done by a neurosurgeon or an orthopaedic surgeon?
All neurosurgeons are trained to do spine surgery. Some orthopaedic surgeons receive additional training in order to specialize in the spine. Both neurosurgeons and orthopaedic surgeons who are fellowship trained have advanced skills in dealing with the more complicated spinal conditions.

How long does it take to recover from minimally invasive surgery compared to traditional back surgery?
While it depends on the condition and what is done, typically recovery times can be cut in half. 

If back pain runs in the family, is there anything you can do to prevent back pain before it starts?
If there is a long family history of back pain, there is probably some genetic component, which you, unfortunately, can't do anything about. However, maintaining a high standard of general health and lifestyle can be even more important. So, eat healthy meals, exercise regularly, keep your weight down and don't smoke. These healthy life choices will lead to benefits in other areas as well. When it comes to exercise though, do low impact exercises—swimming and biking—and avoid running on hard surfaces and heavy lifting.

How long do you continue to recover and improve after surgery? When can you expect to be at your "best" after having back surgery?
It depends on your condition, and what you've had done. For instance, a simple microdiscectomy (the removal of a small section of bone from a disc or from near a nerve to relieve neural impingement) can take a few days to a few weeks but a spinal fusion (the permanent joining of two or more bones in the spine) can take several weeks to months.

What are the best things a patient can do prior to surgery to increase the likelihood of a good outcome after surgery? If there is no medical reason that requires immediate surgery, then programs of weight loss, as well as increasing abdominal strength and overall strength prior to surgery could help increase the speed of recovery after surgery. And a big one: if you smoke, stop.

What does rehab after back surgery involve? How long does it take?
This depends on a patient’s condition and what was done surgically. In general, rehabilitation involves exercises that seek to restore flexibility and improve core strength. Typical recommended rehab after surgery is usually 2-3 sessions per week for 4-6 weeks.