B a c k / N e c k
Surgical and non-surgical interventions for spinal disorders
B a c k / N e c k
Orthopaedic and Spinal Surgeon
MBBS (Hons 1) MS (Ortho) Dip. Anat FRACS FAOrthA PFET (Spine) CIME
Adjunct Assistant Professor, Bond University, Queensland
P - 0499 NEC BAC
[0499 632 222]
F - (07) 3009 9992
P.O. Box 211 Isle of Capri QLD 4217
Non-surgical treatments for Low Back Pain
CAUSE / TARGET TREATMENT OPTIONS Efficacy/Evidence
Disc Disc biacuplasty High (RCT)
Intradiscal biologics (PRP/Stem Cell/A2M/Discseel) Mixed
Annuloplasty/Plasma disc decompression Mixed
Hydrafil / PerQdisc Mixed
Vertebrae Basivertebral nerve ablation High (RCT)
Facet Facet blocks (local/steroid) Short term
Radiofrequency Facet denervation/pulsing Mixed
Poor Muscular control/ Restorative neurostimulation High (RCT)
Instability (Please visit 'Multifidus' page)
Interspinous impingement Steroids -
Irritated nerves Epidural or nerve root steroid Short term
Nerve pulsing Short-medium term
Dorsal root ganglion stimulation Mixed
Sacroiliac joint /Cluneal pain Steroid injections/Fibrous PRP Short term
Radiofrequency denervation Short-medium term
Cooled radiofrequency Medium term - High Level
Peripheral cluneal stim. (Stimwave/Nalu)
Fracture Vertebroplasty/kyphoplasty Mixed
Gray ramus communicans block Short term
Post spinal surgery Spinal (dorsal column) stimulation High (RCT)
(No surgical target)
From top left, clockwise to bottom left:
Interlaminar Epidural,
Radiofrequency facet denervation, Nerve root pulsing, Disc biacuplasty,
Multifidus (ReActiv8TM) and spinal cord stimulation, Basivertebral nerve ablation, Sacroiliac joint injection
To learn more about surgical options click other website options to right
For layperson consumer summary of surgical treatment for back pain - disc replacement vs fusion (USA) please visit:
https://www.verywellhealth.com/total-disc-replacement-or-spinal-fusion-297279
For an academic summary of operative management please see review which Dr Zotti helped to author:
Please note that the above algorithm is suggestive and does not constitute medical advice or the type of procedure that will be recommended. Often problems co-exist that will require a tailored or a la carte approach to treatment multiple or segmental problems.
