Should I Have Surgery for Lumbar Spondylosis?

Question: I’ve had lumbar spondylosis for the last 4 years and have found zero relief with physical therapy, exercise, and medications. The pain is consistently about an 8 out of 10. I’ve just started to research surgery for spondylosis. Could surgery help me?
─Kennett, MO
professional businessman using a tabletAnswer: Let me start off by saying that lumbar spondylosis—also called spinal arthritis and spinal osteoarthritis—is a wide-ranging term doctors use to describe the appearance of degenerative changes in your spine.

Spondylosis can actually be considered a normal part of getting older, which means that over time, parts of the spine (eg, joints, ligaments, intervertebral discs) can start to wear and tear.

It’s important to note that spondylosis can affect all regions of the spine, including the cervical spine (neck) and thoracic spine (mid-back)—not just your lumbar spine (low back). Your symptoms will largely depend on where the spondylosis is in your spine.

In your situation, you have consistent pain. While pain that’s ranked an 8 out of 10 should be closely monitored by your doctor, surgery in your situation may not be necessary.

You mentioned that you’ve already tried several non-surgical treatments (ie, physical therapy, exercise, and medications). But how long have you tried these for? Sometimes it can take several months to notice major benefits of non-surgical treatments. And you may actually need a combination of these treatments to effectively reduce your pain.

Typically, maintaining a healthy weight, exercising regularly, quitting smoking (if you’re a smoker), and monitoring other health conditions you have can significantly help to reduce your back pain and other spondylosis symptoms.

However, there are certain situations (which may be the case with you) where the exact source of the back pain is not entirely clear to your primary care doctor, and he or she can recommend a spine surgeon.

At your initial appointment with the surgeon, he or she will ask about your medical history and perform special tests to see exactly which vertebrae are being affected by the spondylosis. Your surgeon may also order imaging tests, such as x-rays, bone scans, or magnetic resonance imaging (MRI) scans, to evaluate the severity of the spondylosis.

If your surgeon identifies a spine condition (eg, a herniated disc) in addition to spondylosis that doesn’t improve with non-surgical treatments (eg, medications), then he or she may suggest surgery.

In general, surgery for spondylosis is pretty rare, but if you have any of the following symptoms (in addition to your back pain), let your doctor know right away.

  • Bowel or bladder dysfunction
  • Neurologic problems, such as weakness, numbness, or tingling in your arms and/or legs
  • Increased difficulty walking due to heaviness or clumsiness of your legs

If your heart’s set on surgery, be sure to ask your doctor lots of questions about spondylosis surgery, including the risks as well as your surgery options. But know that ultimately the decision to have spine surgery is up to you.