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What is the Difference Between Open Back Surgery Versus the Alternatives?


The decision to undergo any type of surgery is a significant one, and this is especially true of spinal procedures. To ensure a positive outcome, you should be prepared to consider a number of factors, including recovery time, steps for rehabilitation, the type of procedure, the facility and the surgeon. 

Any surgery involves risks, but when people think of open back surgery, they sometimes become reluctant due to the high degree of potential complications and the often difficult recovery involved. This is why so many patients ask if there are alternatives to open back surgery that can help reduce these risks and difficulties. 

One major alternative is minimally invasive surgery for the spine. By using specialized techniques and new advances in surgical technology, surgeons can access the spine through a smaller incision and with less impact on surrounding soft tissue. 

To help you learn more about the difference between open back surgery and alternatives such as minimally invasive surgery, the USA Spine Care team is happy to share the following guide. We welcome you to get in touch with one of our caring and dedicated representatives if you’d like to learn more or for answers to any questions. We’re here to help.  

What does the term “open back surgery” mean?

The term open back surgery refers to traditional approaches to spine surgery that involve a large incision to access the surgical site and perform a required procedure. To be able to see the affected area, spine surgeons literally have to fully “open up” the back, which typically requires cutting and severing the supporting structures around the spine. For the muscles, tendons and ligaments to fully heal, patients can expect a long recovery time and a challenging rehabilitation period. 

Additionally, due to the invasiveness of open back surgery, these procedures also require overnight hospitalization that can take one night or even longer for procedures such as a full open back fusion. This exposes patients to hospital-based infection as well as increased hospital-associated costs. 

Open back surgery also involves increased scarring due to the need for large incisions that can be six to eight inches. In some cases, traditional open back fusion procedures performed at multiple levels may even need longer incisions.

The primary surgical alternative to open back surgery is minimally invasive surgery

With the continuing development of surgical techniques and microsurgical technology, spine surgeons are able to take a far less invasive approach to spine surgery. With minimally invasive surgery, patients can expect a smaller incision, less cutting and tearing of muscle and soft tissue, an outpatient procedure and less risk of complication.

By using direct visualization technology, such as an endoscope or a fluoroscope, surgeons no longer need to open up the back to reach the surgical site. This is also helped by the development of tools and techniques that allow the muscles to be gently spread or moved aside instead of cutting or severing them. 

How alternatives to open back surgery affect recovery time 

Minimally invasive surgery allows surgeons to perform the same procedures, such as laminotomy, discectomy or foraminotomy, while streamlining the patient experience and limiting recovery time. This is even true for certain types of minimally invasive back fusion, also known as minimally invasive stabilization, which can be performed on an outpatient basis. 

After a minimally invasive decompression or minimally invasive stabilization procedure, patients can expect to be up and walking within hours. The postoperative team will check vitals and give full instructions for recovery and incision care before discharging the patient to their home or even a nearby hotel. 

Because there is less healing of important supporting muscles required, patients can typically regain function and mobility on a faster timetable compared to open back surgery. By starting the rehabilitation process sooner, patients can often return to daily activities and work faster as well. However, it is critical to follow any recovery instructions and not rush returning to daily activities without being cleared by your surgical team or your physician. 

Becoming a candidate for spine surgery

Any type of back surgery for degenerative spine conditions usually becomes a consideration after fully exploring nonsurgical therapies. This includes rest, over-the-counter medication, epidural steroid injections and physical therapy. When consulting for surgery, patients should always discuss the possibility of undergoing minimally invasive surgery compared to open back surgery. Although there are cases where a minimally invasive procedure may not be possible due to certain conditions or preexisting health issues, the advantages are significant enough to always warrant consideration. 

Patients will generally undergo a thorough evaluation, including a hands-on examination, review of medical history, review of diagnostic imagery and other testing to determine the right procedure and the best approach for surgery. 

The USA Spine Care difference

If you are considering your surgical options and have concerns about open back surgery, reach out to the expert team at USA Spine Care. At our state-of-the-art outpatient facilities, we have highly skilled, board-certified surgeons with extensive experience in performing minimally invasive surgery to treat a wide spectrum of spine conditions. 

We take a multidisciplinary, patient-centered approach that can help patients on any stage of their treatment journey. Whether you are still exploring conservative options or you are seriously looking at surgery, we can help you build a personalized treatment plan that is right for your treatment goals. 

Call 813-497-2952 today. 

Open Back Surgery Quick Answers

What is open back surgery?

Open back surgery is a term for traditional spine procedures that use large incisions to access the spine, essentially “opening up” the back. To do this requires severing muscles, tendons and ligaments surrounding the spinal column, which can take a significant time to heal. As an alternative, surgeons can now perform minimally invasive spine procedures that use special techniques and visualization technology to limit muscle disruption and allow for a smaller incision. 

How long does it take to recover from open back surgery?

Due to the amount of soft tissue disruption and the large incision required, open back surgery typically requires overnight hospitalization. The duration of the hospital stay can range anywhere from one to five nights. After discharge, it can take as long as three months or more to fully recover from most traditional open back procedures. 

When is open back surgery required?

Any type of spine surgery usually becomes a consideration if conservative therapies have been fully exhausted without achieving the pain relief and mobility needed to engage in normal activities. Inpatient surgery to monitor patients with certain comorbidities or who need multilevel surgery may be required in some cases. However, whether inpatient or outpatient, a large number of spine procedures can be performed using minimally invasive techniques that involve a smaller incision and less muscle disruption. 

What are the risks of open back surgery? 

Due to the large incision, cutting and tearing of soft tissue and the need for a hospital setting, traditional open back surgery carries a number of risks. These include increased scarring, risk of infection and failed back surgery syndrome. Patients also have an increased risk of experiencing a longer and more difficult recovery time.

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