Surgery of the spine is technically complicated, but the ideas are very basic. If there is a pinched nerve, then decompress it. If the spine is unstable, fuse it. However, the application of the scientific method to determine how well a surgery is expected to do, is not consistent. The controversy and risk of the spine surgery is that not all surgery will get better, there are no guarantees, but discussing your individual situation with your surgeon will allow you to make your best decision. Always get as much information as you need.
Therefore, when all treatments have been exhausted, surgery can be discussed. Only an experienced spine surgeon can give detailed information for surgery. Spine Surgery has a great deal of complexity, controversy is common, but there are basic standards that can be followed. The main reasons for surgerical treatment are for unremitting nerve pain, neurologic deficit or potential nerve damage, or mechanical instability or deformity. The most controversial reason for surgery is a fusion for degenerative or "bulging" disks. These issues clearly need a personal discussion of each individual's need with the surgeon. Use this web page as information, not as a substitute for a surgeon's consultation.