Surgery becomes a reasonable option when nonsurgical care hasn't controlled your symptoms, when pain and disability are significant, or when there is a problem that surgery addresses better than time — such as a nerve or spinal cord under enough pressure to threaten its function. The sections below explain the most common operations. Which one is right for you depends on your diagnosis, which levels are involved, your anatomy, your bone quality, and your goals — the "best" operation is the one matched to your specific problem.
Neck (cervical) surgery
ACDF (Anterior Cervical Discectomy and Fusion)
Removing a problem disc through the front of the neck and fusing the level.
Cervical Disc Replacement
An artificial disc that relieves pressure while preserving motion.
Posterior Cervical Foraminotomy
Freeing a pinched nerve from the back of the neck without a fusion.
Cervical Laminoplasty
Creating more room for the spinal cord across several levels while preserving motion.
Posterior Cervical Decompression & Fusion
Decompressing the spinal cord over several levels and stabilizing with a fusion.
Cervical operations at a glance
| Operation | Where / approach | Fuses the spine? | Preserves motion? | Typically used for |
|---|---|---|---|---|
| ACDF | Front of neck | Yes | No | Disc herniation / stenosis, 1–2 levels1 |
| Cervical disc replacement | Front of neck | No | Yes | Disc disease in good candidates, 1–2 levels |
| Posterior foraminotomy | Back of neck | No | Yes | One-sided pinched nerve, no cord compression2 |
| Laminoplasty | Back of neck | No | Yes (largely) | Multilevel cord compression, good curve, no instability3 |
| PCDF | Back of neck | Yes | No | Multilevel cord compression with instability or reversed curve |
Low back (lumbar) surgery
Lumbar Discectomy: Open, Tubular & Endoscopic
Removing the piece of herniated disc pressing on a nerve, through one of three approaches.
Lumbar Decompression (Laminectomy)
Making more room for the nerves, and when fusion is or isn’t needed.
Lumbar Fusion: PLF, TLIF, XLIF/LLIF & ALIF
Stabilizing a painful or unstable level, and how the different approaches compare.
Adult Scoliosis & Deformity Surgery
Realigning and stabilizing the spine when curvature or imbalance limits daily life.
Surgery is rarely the first step
Most spine problems improve with time and non-surgical care. These pages are here so that if surgery does come up, you understand exactly what is being recommended and why.
Sources
- Hu Y, et al. Mid- to long-term outcomes of cervical disc arthroplasty versus anterior cervical discectomy and fusion: a systematic review and meta-analysis of eight prospective randomized controlled trials. PLoS One. 2016. PubMed
- Simões de Souza NF, et al. Posterior cervical foraminotomy compared with ACDF for cervical radiculopathy: two-year results of the FACET randomized noninferiority study. Journal of Bone and Joint Surgery. 2024. PubMed
- Yang E, et al. Cervical laminoplasty versus laminectomy and posterior cervical fusion for cervical myelopathy: propensity-matched analysis of 24-month outcomes from the Quality Outcomes Database. Journal of Neurosurgery: Spine. 2023. PubMed