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I'm going to have back surgery in the next few weeks. The surgeon has offered to just take out the problem disc. Another option is to remove the disk and take out a piece of the bone along the spine. Taking out the bone takes pressure off the nerves. I could have both operations at the same time and save myself the trouble later. What works best?

There's a lot of confusion about spine surgery right now. There aren't enough studies to show what works best or how long the results last.

Research does show that there's a wide range around the country of what's done and how successful it is. Some surgeons just do a discectomy. Others perform the decompressive laminectomy you described. A third option is to have a spinal fusion after discectomy. The idea is to reduce the need for a second operation later by doing both procedures now.

The problem is that studies show patients who have spinal fusion surgery aren't less likely to have another operation. In fact, just having back surgery of any kind increases the risk of reoperation at a later date.

And the rate of complications goes up when discectomy is done with a spinal fusion compared to discectomy without fusion. Age is a factor, too. Older patients have a higher risk of problems after spine surgery. They are more likely to end up in a nursing home after a spinal fusion.

Talk to your doctor about your case before making a final decision. Take into consideration your general health, diagnosis, age, and research findings to date. So far it looks like the more conservative surgical approach is just as good as combining several operations together.

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