Operative treatment of back pain

 When back pain is caused by a compression fracture of a vertebra due to osteoporosisor trauma, doctors may make a small incision in the skin over the affected areaand inject a cement-like mixture called polymethyacrylate into the fracturedvertebra to relievepain and stabilize the spine. The procedure is generally performed on anoutpatient basis under a mild anesthetic.3 Used only if standard care, rest, corsets/braces, analgesics fail.Kyphoplasty: Much like vertebroplasty, kyphoplasty is used to relievepain and stabilize the spine following fractures due to osteoporosis.Kyphoplasty is a two-step process. In the first step, the doctor inserts aballoon device to help restore the height and shape of the spine. In the secondstep, he or she injects polymethyacrylate to repair the fractured vertebra. Theprocedure is done under anesthesia, and in some cases it is performed on anoutpatient basis.For Discogenic Low Back Pain (Degenerative Disc Disease)Intradiscal electrothermal therapy (IDT): One of the newest and least invasivetherapies for low back pain involves inserting a heating wire through a smallincision in the back and into a disc. An electrical current is then passedthrough the wire to strengthen the collagen fibers that hold the disc together.The procedure is done on an outpatient basis, often under local anesthesia. Theusefulness of IDT is debatable.Spinal fusion: When the degenerated disc is painful, the surgeon may recommendremoving it and fusing the disc to help with the pain. This fusion can be donethrough the abdomen, a procedure known as anterior lumbar interbody fusion, orthrough the back, called posterior fusion. Theoretically, fusion surgery shouldeliminate the source of pain; the procedure is successful in about 60 to 70percent of cases. Fusion for low back pain or any spinal surgeries should onlybe done as a last resort, and the patient should be fully informed of risks.