Decompression
When nerves are compressed, they need to be decompressed, since compression of nerves is often a treatable cause of pain. "Decompression" refers to the release of pressure on the nerves or spinal cord. The various decompression surgical methods can be divided into anterior (from the front) versus posterior (from the back).
Spinal Fusion
Spinal fusion is a surgical procedure where the goal is to covert two or more bones into one. This surgery, when successful, limits the movement of these bones, which often helps to relieve pain especially when due to arthritis changes or deformity, and is done non-operative treatments have failed. After a successful fusion, the operated region (back or neck) won’t be quite as flexible. Even so, very often patients feel they have more motion, as their pain is better. However, as with any surgery, the only guarantee is that there is no guarantee.
Instrumentation
"Instrumentation" is the word that describes the use of hardware, plates, screws, rods, that help to stabilize the spine when a fusion is performed. The hardware greatly improves the chances that the fusion will fuse. Though patients often ask if the hardware needs to be removed, this need arises only in a small minority of cases, usually when some type of revision is done.
Since any revision would likely occur in several years, if needed at all, I often recommend to patients to find the name of the company that made their hardware, or get a copy of their operation report. If a subsequent surgery is needed, for example, ten years later, it is often helpful for the future surgeon to know which company made the hardware since sometimes special instruments are needed to get it out. However, since most patients don't know this information, we do the best we can. Just a helpful hint for your future self.
Minimally Invasive Surgery
Minimally invasive and less invasive surgical techniques seek to minimize the damaging effects of large muscle dissection or retraction. A large wound, with prolonged tissue retraction, though often needed, can decrease the local blood flow to the operated areas making healing more challenging. The minimally invasive techniques, when appropriate, leave the surrounding tissues less perturbed. With the goal being to achieve rapid recovery, lessen post-operative pain, and leave cosmetically satisfying incisional scars, minimally invasive techniques are often advantageous. However, sometimes the surgeon will need more access and visualization than can be provided with minimally invasive techniques.
Disc Replacement
As a spine is like a chain, with multiple links, if you weld together two or more links, more pressure or stress is transferred to the next link. Similarly, when one or more spinal segments are fused together, more stress is placed on the adjacent level. The idea of replacing (instead of fusing) spinal discs is to maintain as much motion as possible, and to protect the adjacent levels. While not appropriate for many cases, due to significant arthritis of the joints in the back from facet arthritis, disc replacement can be considered in some cases, more often in the cervical spine.