Spine surgery: what it is and how clinics abroad price it

Spine surgery is an operation on the bones, discs or nerves of the back or neck. Clinics abroad mainly sell three kinds: decompression, fusion and artificial disc replacement.

What does it involve?

• Discectomy — removal of all or part of a disc, the cushion between the spinal bones. In a microdiscectomy the surgeon works through a small cut using a microscope, as MedlinePlus describes.
• Laminectomy (decompression) — removal of part of a spinal bone, called the lamina, to give the nerves or spinal cord more room. MedlinePlus notes it may be combined with a discectomy or fusion.
• Spinal fusion — two or more spinal bones are joined permanently so they no longer move. The surgeon uses bone graft and often cages, screws or rods; see MedlinePlus.
• Artificial disc replacement — a worn disc is removed and replaced with a prosthetic disc, aiming to keep more motion than fusion. The American Academy of Orthopaedic Surgeons describes the procedure.

These operations are usually done under general anesthetic. Many combine more than one step, for example a decompression followed by a fusion.

How do clinics price it?

This topic does not have price tables on the site yet. Clinics usually publish spine surgery prices in these units:

• Per procedure — a package price for one named operation.
• Per spinal level — the price depends on how many levels (segments of the spine) are treated. A one-level fusion and a two-level fusion are priced differently.
• Per package with a set number of hospital nights — the price covers a fixed stay.

A package price may include the surgeon's and anesthesiologist's fees, the operating room, a set number of hospital nights, and standard medication during the stay. Clinics often charge extra for scans and tests before surgery, implants (screws, rods, cages or an artificial disc, which can differ by brand), extra nights, physiotherapy, a brace, medication to take home, and follow-up. Travel and accommodation are not included.

Prices are only comparable within the same unit, the same procedure and the same number of levels.

What should I ask the clinic before paying?

• Which exact procedure is included, at which part of the spine, and at how many levels?
• Which implants are included, by type and brand, and are they part of the price?
• Who is the operating surgeon? Ask for the name and qualification as a spine, orthopedic or neurosurgeon (see how to check a doctor).
• How many hospital nights are included, and what does each extra night cost?
• Is physiotherapy during the stay included?
• What happens, and who pays, if a second operation is needed?
• What follow-up does the clinic offer after you return home, and how long is the quoted price valid in writing?

What this page does not tell you

This page reports what clinics publish about prices and terms. It does not say whether spine surgery is right for you, which operation to choose, or how it will turn out. Those decisions belong with your own doctor. For non-surgical options sold abroad, see pain management. A second medical opinion is listed separately on this site.