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Surgical vs Nonsurgical Spine Care: What an Orthopedic Spine Specialist Will Recommend

July 4, 2025

An orthopedic spine specialist examining a patient with a spinal injury in a medical facility during a treatment session.

In short…

  • A Nonsurgical Approach Takes Priority: Nonsurgical treatment with an orthopedic spine specialist is most often the first line of defense until surgical intervention is necessary.
  • Nonsurgical Treatment Benefits: Minimally invasive options, like neurostimulation, reduce the need for hospital stays and lengthy recovery periods.
  • Finding High-Quality Care: Finding a qualified orthopedic spine specialist is essential for receiving comprehensive, high-quality care.

The choice between nonsurgical and surgical spine care is not all black and white. This nuanced decision requires a thorough assessment of your specific condition, its severity, your overall health, and your lifestyle, among other factors. With the results in hand, your orthopedic spine specialist will work closely with you to determine the best path forward, whether that is conservative care or surgical intervention.

If you are searching for low back pain treatment near you or a good orthopedic spine specialist, keep reading.

Why Conservative (Nonsurgical) Care Often Comes First

Surgery is an essential tool, but it is not the first one orthopedic spine specialists reach for, as it does come with significant risks. Orthopedic treatment for back pain almost always begins with nonsurgical treatment.

Your doctor may recommend any or some of the following:

  • Physical therapy: Deemed the cornerstone of nonoperative spine rehabilitation, physical therapy not only helps alleviate pain; it also effectively strengthens your spine, improves your posture and body mechanics, and restores normal function.
  • Oral medications: Your doctor may prescribe medications to help relieve pain and muscle tension.
  • Epidural steroid injections (ESI): ESIs also tamp down inflammation, providing significant relief up to several months.
  • Activity modification: Simple changes like using a lumbar-supportive chair, taking frequent breaks from prolonged sitting, and learning how to lift with your legs instead of your back can significantly reduce the strain on your spine and help improve your symptoms.
  • Orthobiologics: These innovative treatments use cells from your own body to jump-start the healing process. Platelet-rich plasma (PRP) therapy, for instance, uses your own blood cells to promote tissue repair and speed up your recovery.

Most patients experience relief through a combination of these methods. In fact, studies demonstrate the effectiveness of nonsurgical treatment modalities in treating up to 90% of spine issues.

When is Surgery Recommended?

While many spine conditions respond well to nonsurgical treatment, there are cases where surgery is the best—or the only—solution.

Surgery is not a decision to be taken lightly. Your orthopedic spine surgeon will carefully weigh various factors to determine whether it is indeed necessary based on your unique condition and symptoms.

Surgery may be recommended if:

  • Nonsurgical treatments have failed. If months of therapy, injections, and medication have not improved your condition, it might be time to consider surgery.
  • There is severe nerve compression involved. In such a case, surgery is necessary to prevent permanent nerve damage.
  • There is a loss of function. Difficulty walking, standing, or controlling your bladder or bowels could indicate a serious problem that needs immediate surgical intervention.
  • There is structural instability in your spine. Issues like spinal fractures or severe deformities typically require surgery to restore stability and ensure proper alignment of the spine.

Your orthopedic spine specialist will likely discuss these with you, along with the advantages and disadvantages, to help you make a well-informed decision.

The Role of Minimally Invasive Spine Surgery Techniques

Spine surgery used to mean long hospital stays and slow recoveries. Fortunately, that has changed dramatically over the years. Many modern spinal procedures are now performed using minimally invasive techniques, which come with remarkable benefits, such as:

  • Shorter hospital stays
  • Faster recovery times
  • Reduced risk of complications
  • Less postoperative pain

Procedures like microdiscectomy, laminectomy, and spinal fusion can often be done this way, depending on your anatomy and diagnosis. This makes surgery a much less intimidating prospect.

Cutting-Edge Solutions to Back Pain 

With the significant advancements in spine technology also comes the emergence of cutting-edge devices designed to target the source of pain. These devices are typically recommended for those who have not found symptom relief with conservative treatments but are not ready for more invasive surgical procedures.

Discussed below are two of the most promising implantable solutions currently available:

  • ReActiv8 Neurostimulation System: Used for mechanical back pain, this surgically implantable device is designed to strengthen your back muscles by delivering electrical impulses to the nerves that activate them.

Much like building muscle at the gym, progress with the device is gradual. But with constant use, it effectively reconditions your back muscles, making them stronger, more supportive, and more resilient over time.

Clinical studies show that patients experience a 50% reduction in pain within the first six months, with improvement rates climbing to 80% after three years.

  • Spinal cord stimulator (SCS) – This is another surgically implantable device, but with a different mechanism of action. An SCS works by sending low-level electrical pulses to your spinal cord to dampen pain signals before they reach your brain. The device can be adjusted externally, allowing you and your spine specialist to fine-tune pain control.

The use of SCS is often recommended for patients with nerve-related back pain, such as from chronic sciatica. It has been shown to provide significant pain relief and improve quality of life, reducing your reliance on medications.

Back Specialist in Central Maryland

Here at the OACM, we are proud to have highly skilled back specialists on our team who hold an impressive track record of helping scores of patients break free from back pain and return to living their best lives.

Our specialists offer a comprehensive range of treatments—from conservative modalities to state-of-the-art treatments like ReActiv8 Neurostimulation System and advanced surgical options like spinal fusion. They prioritize involving you at every step of the decision-making process to ensure the treatment plan perfectly aligns with your unique needs.

To schedule a consultation with one of our spine experts, call our office at (410) 644-1880 or use our online appointment scheduling tool.

Filed Under: Orthopedic Doctor Tagged With: Back Specialist in Central Maryland, back specialist near me, low back pain treatment near me, Minimally Invasive Spine Surgery Techniques, nonoperative spine rehabilitation, orthopedic for back pain, orthopedic spine specialist near me, physical therapy, spine conditions, surgical spine care

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The Centers for Advanced Orthopaedics Orthopaedic Associates of Central Maryland Division is your premier center for comprehensive physical therapy and orthopedic services for conditions affecting the back and neck, foot and ankle, hand and wrist, hip and knee, and shoulder and elbow. We are also proud to offer a Bone Health Program, nonoperative treatments, after-hours care, and on-site imaging at our 12 locations across Central Maryland.