This information will help you prepare for your endoscopic third ventriculostomy (ETV) surgery at Memorial Sloan Kettering (MSK). It will also help you understand what to expect during your recovery.
You can find more information on our web, so please take a look.
Read through this information at least once before your surgery and use it as a reference in the days leading up to your surgery. Bring this resource with you every time you come to MSK, including the day of your surgery. You and your healthcare team will refer to it throughout your care.
For the rest of this resource, our use of the words “you” and “your” refers to you or your child.
ETV is a surgery to drain extra cerebrospinal fluid (CSF) from your brain. CSF is the fluid that surrounds your brain and spinal cord. It’s made in the ventricles (hollow spaces) inside your brain.
CSF protects your brain and spinal cord by acting like a cushion. However, when you have too much of it, it puts pressure on your brain and skull. This extra fluid also makes your ventricles grow bigger (see Figure 1). This is called hydrocephalus (hy-dro-ceph-a-lus).
Figure 1. Brain with and without hydrocephalus
The most common symptoms of hydrocephalus include:
Your ETV surgery will be done in the operating room. Before your surgery, you will get anesthesia (medication to make you sleep during your surgery). Once you’re asleep, a nurse will shave the hair in the area where your incisions (surgical cuts) will be. Your entire head won’t be shaved.
During your surgery, your neurosurgeon will make a tiny hole in the third ventricle of your brain (see Figure 2). This will let the excess CSF drain into another area of your brain to be absorbed.
Figure 2. ETV
The information in this section will help you prepare for your surgery.
Read through this section when your surgery is scheduled and refer to it as your surgery date gets closer. It contains important information about what you need to do before your surgery. Write down any questions you have and be sure to ask your doctor or nurse.
You and your healthcare team will work together to get ready for your surgery.
Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you aren’t sure.
The amount of alcohol you drink can affect you during and after your surgery. It’s important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.
Here are things you can do to prevent problems before your surgery:
People who smoke can have breathing problems when they have surgery. Stopping even for a few days before surgery can help.
MSK has specialists who can help you quit smoking. For more information about our Tobacco Treatment Program, call 212-610-0507. You can also ask your nurse about the program.
Sleep apnea is a common breathing disorder that causes a person to stop breathing for short periods of time while sleeping. The most common type is obstructive sleep apnea (OSA). With OSA, the airway becomes completely blocked during sleep. It can cause serious problems during and after surgery.
Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing machine (such as a CPAP) for sleep apnea, bring it with you the day of your surgery.
Before your surgery, you will have an appointment for presurgical testing (PST). Depending on your age, your testing can take place in a variety of places. The date, time, and location of your PST appointment will be printed on the appointment reminder from your surgeon’s office.
Your appointment will be at one of the following places:
You can eat and take your usual medications the day of your PST appointment.
During your appointment, you will meet with a nurse practitioner (NP) who works closely with anesthesiology staff (doctors and specialized nurses who will give you anesthesia during your surgery). Your NP will review your medical and surgical history with you. You will have tests, including an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests needed to plan your care. Your NP may also recommend you see other healthcare providers.
Your NP will talk with you about which medications you should take the morning of your surgery.
It’s very helpful to bring the following things to your PST appointment:
The PACC is located at Memorial Hospital (MSK’s main hospital). The address is:
1275 York Avenue (between East 67th and East 68th Streets)
New York, NY 10065
Take the B elevator to the 9th floor
MSK’s parking garage is located on East 66th Street between York and First Avenues. If you have questions about prices, call 212-639-2338.
To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that you can walk through that connects the garage to the hospital.
There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.
PST is located in the Rockefeller Outpatient Pavilion, also known as MSK 53rd Street. The address is:
Rockefeller Outpatient Pavilion
160 East 53rd Street (at Third Avenue)
New York, NY 10022
There are several options for parking during your PST appointment. The Bristol Garage offers discounts to patients. To receive the discount, have your parking ticket validated at the concierge desk in the Rockefeller Outpatient Pavilion. There is a shuttle that goes from the Bristol Garage to the Rockefeller Outpatient Pavilion every 20 minutes.
The Bristol Garage
300 East 56th Street (between First and Second Avenues)
New York, NY 10022
There are additional parking garages located at East 53rd Street between Second and Third Avenues and East 54th Street between Second and Third Avenues.
The Ronald McDonald House provides temporary housing for out-of-town pediatric patients and their families. MSK also has arrangements with several local hotels and housing facilities that may give you a special reduced rate. Your social worker can discuss your options and make reservations.
If you develop any illness before your surgery, call the doctor who scheduled your surgery. This includes a fever, cold, sore throat, or the flu.
If you take vitamin E, stop taking it 10 days before your surgery. Vitamin E can cause bleeding. For more information, read our resource How To Check if a Medicine or Supplement Has Aspirin, Other NSAIDs, Vitamin E, or Fish Oil.
If you take aspirin, ask your surgeon if you should keep taking it. Aspirin and medications that contain aspirin can cause bleeding. For more information, read our resource How To Check if a Medicine or Supplement Has Aspirin, Other NSAIDs, Vitamin E, or Fish Oil.
Stop taking herbal remedies and other dietary supplements 7 days before your surgery. If you take a multivitamin, ask your doctor or nurse if you should keep taking it. For more information, read our resource Herbal Remedies and Cancer Treatment.
Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®), 2 days before your surgery. These medications can cause bleeding. For more information, read our resource How To Check if a Medicine or Supplement Has Aspirin, Other NSAIDs, Vitamin E, or Fish Oil.
A clerk from the Admitting Office will call you after the day before your surgery. If you’re scheduled for surgery on a Monday, you will be called on the Friday before.
The clerk will tell you what time you should arrive at the hospital for your surgery. They will also tell you where to go on the day of your surgery. This will be one of the following locations:
If you don’t receive a call by , please call 212-639-7056.
Unless you’re given other instructions, you can shower and wash your hair. Do not use any hair products such as hair spray or gel.
Go to bed early and get a full night’s sleep.
Do not eat or drink anything after a certain time on the night before your surgery. This exact time is based on your age and any other medical problems that you may have. Your NP will talk with you about what you can and cannot eat before surgery.
If you do not follow the instructions you are given, your surgery may be cancelled.
If your doctor or NP instructed you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take and the surgery you’re having, this may be all, some, or none of your usual morning medications.
Starting 2 hours before your surgery, do not take any medications.
Do not eat or drink anything the morning of your surgery. This includes water, hard candy, and gum. Take any medication as instructed with a sip of water.
For information about parking at Memorial Hospital, read the “Parking at the PACC” section.
You will be asked to state and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having surgery on the same day.
When it’s time to change for surgery, you will get a hospital gown, robe, and nonskid socks to wear.
You will meet with your nurse before surgery. Tell your nurse the dose of any medications (including patches and creams) you took after midnight and the time you took them.
Your anesthesiologist will:
You will either walk into the operating room or be taken in on a stretcher. A member of the operating room team will help you onto the operating bed. Compression boots will be placed on your lower legs. These gently inflate and deflate to help blood flow in your legs.
Once you’re comfortable, your anesthesiologist will give you anesthesia through your IV line, MediPort®, or central line, and you will fall asleep.
Once you’re asleep, your surgery will begin. You won’t feel any pain during your surgery.
The information in this section will tell you what to expect after your surgery, both during your hospital stay and after you leave the hospital. You will learn how to safely recover from your surgery. Write down any questions you have and be sure to ask your doctor or nurse.
When you wake up after your surgery, you will be in the Post Anesthesia Recovery Unit (PACU).
You may have a mask over your face that will give you air and help you wake up after surgery. You will be attached to machines that will monitor your body temperature, heart rate, blood pressure, and oxygen level. You may also have dressings (bandages) over your incisions.
It’s normal to feel very tired after surgery. Your PACU nurse will make sure you’re comfortable and answer any of your questions.
Once you’re awake and your pain is under control, you will be taken to your hospital room. Depending on your age and condition, you may be taken to the Pediatric Intensive Care Unit (PICU), the Adult Intensive Care Unit (ICU), or the Neurology Advanced Care Unit (NACU) for close observation and monitoring.
Read our resource Call! Don't Fall! for Pediatric Patients for information about how to avoid falling and stay safe while you’re in the hospital.
After 24 hours, you will be taken to the pediatric or neurology floor for continued care. If you have a bandage over your incision, your doctor will take it off around this time. After the bandage is removed, your incision(s) will be left uncovered.
While you’re in the hospital, you will frequently be asked to move your arms, fingers, toes and legs. Your nurse will check your pupils with a flashlight and ask questions such as “What is your name?”
You may have a mild headache or feel discomfort from your incision for the first few days after your surgery. Your nurse will give you pain medication. Please tell your nurse if the medication isn’t helping your pain.
You may have a sore throat after your surgery. This is caused by the breathing tube that was used during your surgery. You will be given cool liquids to drink and lozenges to suck on to help with the discomfort.
Most people stay in the hospital 1 night, but this will depend on your recovery.
Parents can call the inpatient unit at any time. Ask your nurse for the phone number. Because of privacy concerns, staff will only give information to parents or spouses. Please tell friends and other relatives not to call the inpatient unit for information.
You will be given ice chips to eat after your surgery. You will start with a liquid diet and then progress to solid food.
The sutures or staples in your incision will be removed 7 to 10 days after your surgery. They may need to stay in longer if you have had this surgery before. Your doctor or NP will remove them during your follow-up visit at the clinic.
Your doctor will tell you when you can go back to work. This depends on your age, type of work, medical condition, and other factors.
You can go back to school as soon as you feel ready. Tell your school nurse that you have an ETV.
You can participate in all noncontact sports (such as swimming and running), exercise, and go to the gym 2 weeks after your surgery. You can’t participate in any contact (collision) sports (such as football, boxing and wresting) until your neurosurgeon says it’s okay. Remember to wear a helmet to decrease the risk of head injury, if needed. Ask your neurosurgeon for specific guidelines on wearing a helmet.
Don’t swim for at least 2 weeks after your surgery. If your incision needs more time to heal, you may need to wait longer. Your doctor or NP will tell you when it’s okay to swim at your first follow-up appointment after your surgery.
Don’t travel on an airplane until your doctor says it’s okay.
You will have regular visits with your neurologist, neurosurgeon, or both. They will monitor the function of your ETV over time.
No. The magnet in the MRI scanner will not affect your ETV.
You should always wear a MedicAlert® bracelet or necklace stating that you have hydrocephalus with an ETV. If you’re ever seriously ill or hurt and need medical help, it will inform emergency services workers about your ETV.
You can buy a MedicAlert bracelet or necklace at most drug stores. For more information, visit the MedicAlert website at www.medicalert.com.
You should also carry a wallet card at all times that states you have hydrocephalus with an ETV. Your nurse will give you a wallet card to fill out.
Call your doctor or NP if you’re having any of the following signs and symptoms that your ETV isn’t working properly or you have an infection:
These warning signs can appear quickly. If any of these signs or symptoms develop, call your doctor or NP immediately.
If you cannot wake your child, call 911 or go to the nearest emergency room immediately.
If you have any questions or concerns, please talk with your doctor or nurse. You can reach them Monday through Friday from to at 212-639-7056.
After , during the weekend, and on holidays, please call 212-639-2000 and ask for the pediatric neurosurgery fellow on call.
This section has a list of support services. They may help you as you get ready for your surgery and recover after your surgery.
As you read this section, write down questions to ask your healthcare provider.
Admitting Office
212-639-7606
Call if you have questions about your hospital admission, such as asking for a private room.
Anesthesia
212-639-6840
Call if you have questions about anesthesia.
Blood Donor Room
212-639-7643
Call for information if you’re interested in donating blood or platelets.
Bobst International Center
332-699-7968
We welcome patients from around the world and offer many services to help. If you’re an international patient, call for help arranging your care.
Caregivers Clinic
www.msk.org/caregivers
Our Caregivers Clinic provides support for caregivers who are having a hard time coping with the demands of being a caregiver. Call Dr. Allison Applebaum’s office at 646-888-0200 to learn more.
Counseling Center
www.msk.org/counseling
646-888-0200
Many people find that counseling helps them. Our Counseling Center offers counseling for individuals, couples, families, and groups. We can also prescribe medicine to help if you feel anxious or depressed. Ask a member of your care team for a referral or call the number above to make an appointment.
Food Pantry Program
646-888-8055
We give food to people in need during their cancer treatment. Talk with a member of your care team or call the number above to learn more.
Integrative Medicine Service
www.msk.org/integrativemedicine
Our Integrative Medicine Service offers many services to complement (go along with) traditional medical care. For example, we offer music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy. Call 646-449-1010 to make an appointment for these services.
You can also schedule a consultation with a healthcare provider in the Integrative Medicine Service. They’ll work with you to make a plan for creating a healthy lifestyle and managing side effects. Call 646-608-8550 to make an appointment for a consultation.
MSK Library
library.mskcc.org
212-639-7439
You can visit our library website or call to talk with the library reference staff. They can help you find more information about a type of cancer. You can also visit the library’s Patient and Health Care Consumer Education Guide.
Nutrition Services
www.msk.org/nutrition
212-639-7312
Our Nutrition Service offers nutritional counseling with one of our clinical dietitian nutritionists. Your clinical dietitian nutritionist will talk with you about your eating habits. They can also give advice on what to eat during and after treatment. Ask a member of your care team for a referral or call the number above to make an appointment.
Patient and Community Education
www.msk.org/pe
Visit our patient and community education website to search for educational resources, videos, and online programs.
Patient Billing
646-227-3378
Call if you have questions about preauthorization with your insurance company. This is also called preapproval.
Patient Representative Office
212-639-7202
Call if you have questions about the Health Care Proxy form or concerns about your care.
Perioperative Nurse Liaison
212-639-5935
Call if you have questions about MSK releasing any information while you’re having surgery.
Private Duty Nurses and Companions
917-862-6373
You can request private nurses or companions to care for you in the hospital and at home. Call to learn more.
Rehabilitation Services
www.msk.org/rehabilitation
Cancers and cancer treatments can make your body feel weak, stiff, or tight. Some can cause lymphedema (swelling). Our physiatrists (rehabilitation medicine doctors), occupational therapists (OTs), and physical therapists (PTs) can help you get back to your usual activities.
Resources for Life After Cancer (RLAC) Program
646-888-8106
At MSK, care does not end after your treatment. The RLAC Program is for patients and their families who have finished treatment.
This program has many services. We offer seminars, workshops, support groups, and counseling on life after treatment. We can also help with insurance and employment issues.
Social Work
www.msk.org/socialwork
212-639-7020
Social workers help patients, families, and friends deal with common issues for people who have cancer. They provide individual counseling and support groups throughout your treatment. They can help you communicate with children and other family members.
Our social workers can also help refer you to community agencies and programs. If you’re having trouble paying your bills, they also have information about financial resources. Call the number above to learn more.
Spiritual Care
212-639-5982
Our chaplains (spiritual counselors) are available to listen, help support family members, and pray. They can contact community clergy or faith groups, or simply be a comforting companion and a spiritual presence. Anyone can ask for spiritual support. You do not have to have a religious affiliation (connection to a religion).
MSK’s interfaith chapel is located near Memorial Hospital’s main lobby. It’s open 24 hours a day. If you have an emergency, call 212-639-2000. Ask for the chaplain on call.
Virtual Programs
www.msk.org/vp
We offer online education and support for patients and caregivers. These are live sessions where you can talk or just listen. You can learn about your diagnosis, what to expect during treatment, and how to prepare for your cancer care.
Sessions are private, free, and led by experts. Visit our website to learn more about Virtual Programs or to register.
Access-A-Ride
web.mta.info/nyct/paratran/guide.htm
877-337-2017
In New York City, the MTA offers a shared ride, door-to-door service for people with disabilities who can’t take the public bus or subway.
Air Charity Network
www.aircharitynetwork.org
877-621-7177
Provides travel to treatment centers.
American Cancer Society (ACS)
www.cancer.org
800-ACS-2345 (800-227-2345)
Offers a variety of information and services, including Hope Lodge, a free place for patients and caregivers to stay during cancer treatment.
Cancer and Careers
www.cancerandcareers.org
646-929-8032
A resource for education, tools, and events for employees with cancer.
CancerCare
www.cancercare.org
800-813-4673
275 Seventh Avenue (Between West 25th & 26th Streets)
New York, NY 10001
Provides counseling, support groups, educational workshops, publications, and financial assistance.
Cancer Support Community
www.cancersupportcommunity.org
Provides support and education to people affected by cancer.
Caregiver Action Network
www.caregiveraction.org
800-896-3650
Provides education and support for people who care for loved ones with a chronic illness or disability.
Corporate Angel Network
www.corpangelnetwork.org
866-328-1313
Offers free travel to treatment across the country using empty seats on corporate jets.
Good Days
www.mygooddays.org
877-968-7233
Offers financial assistance to pay for copayments during treatment. Patients must have medical insurance, meet the income criteria, and be prescribed medicine that’s part of the Good Days formulary.
HealthWell Foundation
www.healthwellfoundation.org
800-675-8416
Provides financial assistance to cover copayments, health care premiums, and deductibles for certain medicines and therapies.
Joe’s House
www.joeshouse.org
877-563-7468
Provides a list of places to stay near treatment centers for people with cancer and their families.
LGBT Cancer Project
www.lgbtcancer.com
Provides support and advocacy for the LGBT community, including online support groups and a database of LGBT-friendly clinical trials.
LIVESTRONG Fertility
www.livestrong.org/we-can-help/fertility-services
855-744-7777
Provides reproductive information and support to cancer patients and survivors whose medical treatments have risks associated with infertility.
Look Good Feel Better Program
www.lookgoodfeelbetter.org
800-395-LOOK (800-395-5665)
This program offers workshops to learn things you can do to help you feel better about your appearance. For more information or to sign up for a workshop, call the number above or visit the program’s website.
National Cancer Institute
www.cancer.gov
800-4-CANCER (800-422-6237)
National LGBT Cancer Network
www.cancer-network.org
Provides education, training, and advocacy for LGBT cancer survivors and those at risk.
Needy Meds
www.needymeds.org
Lists Patient Assistance Programs for brand and generic name medicines.
With competitive price and timely delivery, Lingchuang Yihui sincerely hope to be your supplier and partner.
NYRx
www.health.ny.gov/health_care/medicaid/program/pharmacy.htm
Provides prescription benefits to eligible employees and retirees of public sector employers in New York State.
Patient Access Network (PAN) Foundation
www.panfoundation.org
866-316-7263
Gives help with copayments for patients with insurance.
Patient Advocate Foundation
www.patientadvocate.org
800-532-5274
Provides access to care, financial assistance, insurance assistance, job retention assistance, and access to the national underinsured resource directory.
Professional Prescription Advice
www.pparx.org
888-477-2669
Helps qualifying patients without prescription drug coverage get free or low-cost medicines.
Red Door Community (formerly known as Gilda’s Club)
www.reddoorcommunity.org
212-647-9700
A place where people living with cancer find social and emotional support through networking, workshops, lectures, and social activities.
RxHope
www.rxhope.com
877-267-0517
Provides assistance to help people get medicines they have trouble affording.
Triage Cancer
www.triagecancer.org
Provides legal, medical, and financial information and resources for cancer patients and their caregivers.
This section lists the educational resources mentioned in this guide. They will help you get ready for your surgery and recover after your surgery.
As you read these resources, write down questions to ask your healthcare provider.
Chronic back pain, in which symptoms are persistent and disrupt daily activities, is very common; about 16 million American adults, or 8% of the population, experience this condition.
Though spinal injection and surgery are both effective treatments for back pain, there are key differences. Injection is the less-invasive option, though results are temporary and multiple treatments are needed. Spinal surgery, correcting the causes of pain, is only attempted after other therapies have been tried.
This article discusses the differences between spinal injections and surgery. Before going ahead with any treatment for back pain, however, make sure to see a healthcare provider for a diagnosis.
ljubaphoto / Getty Images
What to Know About Spinal Injection
When back pain lasts longer than three months, it’s considered chronic. Healthcare providers are typically conservative with treatment, with spinal injection considered only if medications, physical therapy, and lifestyle changes haven’t yielded results. As part of a broader management plan, this treatment provides sustained, though not permanent, relief from symptoms.
How Does It Work?
A spinal injection may be used to diagnose back problems, or as a therapy to manage pain. The goal is to introduce a solution of local anesthetic and anti-inflammatory medications (typically corticosteroids) near affected nerves in the spine. This approach is considered in a wide range of cases, including:
The pain-managing effects of spinal injections are not permanent, and overall success rates depend on the issue being treated and the specific approach used.
One study comparing different types of spinal injections for lumbar slipped discs found between 10% and 25% of patients reported poor improvement at one year. However, the others had at least fair results, with between 9.76% and 37.5% seeing “excellent” improvement.
Spinal Injection Delivery
Generally, spinal injections are indicated along with muscle-strengthening and stretching exercises to improve stability and strength. To ensure the proper position of the injection, healthcare providers use a special kind of X-ray guidance called fluoroscopy. This involves injecting a contrast dye into the bloodstream, which provides a better, more accurate picture of the targeted area.
For back pain, the three primary types of spinal injection are:
The pain-managing effects set in within a couple of days after treatment, with pain relief typically seen for three to six months afterward (though it can last longer), depending on the case. You’ll be carefully monitored after treatment, and additional injections, or other alternatives, will be explored if the issues don’t go away.
Side Effects
Spinal injections are generally well-tolerated, and the risk of complications is low. Common side effects, attributed to the corticosteroids used, include:
In rare cases, there’s a risk of the following:
Prices & Where to Get It
As with any medical treatment, how much you pay depends not only on your individual case but on your insurance coverage, the location of the treatment, and the healthcare provider offering it. There also may be out-of-pocket costs to consider, such as travel and lodging to a clinic. In 2021, the costs of these treatments ranged from $90 to $1,000 per injection.
Speak to an insurance company representative and your healthcare provider’s office staff to understand your expenses and options. Even without insurance coverage, there may be financing options available.
What to Know About Spinal Surgery
Though it’s the only option in some cases, about 80% of chronic back pain patients find relief without spinal surgery. There are several different types of surgery for the spine, but all aim to correct the underlying causes of back pain. The decision to go ahead should be made with careful consultation with your provider and a spinal surgeon.
How Does It Work?
Spinal surgeries are only performed when there’s an identified and specific back problem. This option is only considered when symptoms haven’t responded to between six weeks and six months of physical therapy, medications, and spinal injections or other treatments.
This type of surgery treats a range of spinal conditions, including:
Though the more invasive option, spinal surgeries get at the root causes of the pain. However, the surgery isn’t appropriate for all patients. Some conditions or other factors increase the chances of complications or adverse events, including:
Research has consistently shown that spinal surgeries are effective in managing pain and inflammation. According to one review, over 50% of all spinal surgeries are successful, with failure rates ranging from 10% to 46% depending on the specific procedure.
In most cases, however, these treatments reduce pain but don’t completely stop it. Studies have shown that pain drops by around 50% up to one year after surgery for sciatica.
Spinal Surgery Delivery
There are many specific spinal surgeries, but they can be broken down into two types. More traditional, open surgeries involve longer incisions and more disruption to muscles as the affected area is exposed and operated upon.
Minimally invasive spine surgery (MISS) techniques rely on smaller incisions, lasers, endoscopic techniques, and specialized tools. This less invasive option typically leads to quicker recovery and requires shorter hospital stays.
Before surgery begins, you’ll undergo imaging, often magnetic resonance imaging (MRI) or X-rays to assess the affected area and guide the procedure. General anesthesia is often used, though some MISS techniques only require a local anesthetic.
There are several kinds of surgery, each with its own advantages and applications. Common types include:
Following surgery, you’ll generally need one to three days of recovery in the hospital. You’ll be given medication and direction on how to manage discomfort as you rehabilitate at home, with follow-up typically necessary one to two weeks after the procedure.
Robototic-assisted spinal surgery was first approved by the Food and Drug Administration (FDA) in 2004. This sophisticated technology allows the surgeon to use a robotic arm capable of very precise movements, minimizing the impact of the treatment and reducing complications.
Side Effects
No matter the type of spinal surgery you have, you can expect to experience some pain and discomfort as you recover. Additionally, there’s a chance of complications, including:
Prices & Where to Get It
Spinal surgeries are among the more complex procedures, and, as with other treatments, many factors determine out-of-pocket costs. Depending on the scope of the work needed, the procedure is in surgical centers or hospitals, which can influence expenses.
The cost also depends on the type of procedure needed, the surgeon performing the work, as well as your insurance plan. In a cost-analysis of lumbar spinal fusion from 2021, the direct costs of treatment ranged from $8,286 to $73,727, for an average of $22,890.
Which Treatment Is Best for You?
So how do spinal injections and surgeries for the spine compare? Each approach has its own set of advantages and disadvantages, as follows:
When meeting your healthcare provider, you will be given presented with options that would be most effective in treating your back pain.
Can Spinal Injection and Spinal Surgery Be Used Together?
Typically, spinal surgery is only considered when other options, including spinal injections, haven’t yielded results. In difficult cases, surgeons may first administer a preoperative epidural injection to affected areas, often the lumbar (or lower) spine, before operating on it. While this combination hasn’t been shown to increase complication risk, it did raise hospital readmission and reoperation rates according to one study.
Not only that, epidural and facet joint injections, and another type, discography, help surgeons diagnose the exact location and cause of the issue. As such, they can play an instrumental role in the process leading up to surgery.
Coping With the Side Effects
Though side effects tend to be more severe with surgery, both spinal surgery and injections can cause side effects. Recovery and rehabilitation from these procedures mean learning how to cope with them. Here’s a quick breakdown of strategies:
Summary
Spinal injection and surgery are both options for treating back pain caused by a wide range of conditions, including sciatica, herniated disc, and spinal stenosis, among others. Injection of pain medication and steroids (the less-invasive option) provides lasting but not permanent relief from symptoms. Surgery, considered only when other treatments haven’t yielded results, focuses on correcting the underlying cause of back pain.
A Word From Verywell
Even though back pain is common, it’s never simple to live with, and there’s no singular treatment for it. If you’re suffering from persistent or chronic spine issues, be proactive about taking charge of your health and getting help.
The physical and emotional burden of living with pain is massive. The pain can impact every aspect of your life, affecting you at work and at home. Fortunately, surgery and injections are two ways to get relief.
Is spinal surgery the only option for treating low back pain?
Generally, spinal surgery is a last resort option, attempted only after other means of managing back pain are not effective. Most don't end up requiring it. Other therapies for chronic pain include:
Learn More
Types of Treatment for Low Back Pain
If I have had a spinal injection, am I candidate for surgery?
It's not uncommon for spinal injections to precede spinal surgery, such as spinal fusion, discectomy, and others. Not only might injections be used diagnostically, helping the surgeon isolate the exact location of the issue, but they may also be attempted as a means to avoid the need for surgery. Studies have found that though injections prior to surgery don't raise complication rates, they may increase the risk of reoperation.
Learn More
Spinal Injections for Treating and Diagnosing Back Pain
How soon will I recover after spinal injection?
A less-invasive option than surgery, spinal injections are well-tolerated and associated with few side effects. The procedure, itself, takes only about 30 to 45 minutes, and you'll recover for about 30 to 60 minutes at the clinic or hospital before going home. The effects set in within a couple of days, and you should be able to resume normal activities after a day. However, this therapy is most effective when paired with physical therapy and certain exercises.
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