Spine Care

We want to find the most effective, least-invasive option to treat symptoms or pain related to your spine. In most cases, our spine experts will suggest conservative options first, but we are proud to offer the full range of minimally invasive and surgical options to meet your needs.

Conservative Treatment Options
Conservative treatments like physical therapy, chiropractic care, manual therapy, acupuncture, medications, bracing, and electrical stimulation are all noninvasive and can often provide substantial pain relief. 

Spine Injections
Spine injections are an effective option for various types of back and neck pain: 

• Diagnostic injections help pinpoint the source of your pain/symptoms using numbing medication.
• Epidural steroid injections treat pain/symptoms originating from the spinal nerves due to inflammation, compression (“pinched nerve”), a narrowed spinal canal, or other irritations. 
• Joint injections target pain that originates within joints, like the facet, sacroiliac (SI), and hip joints.
• Nerve block injections use a mixture of numbing medicine and steroids to treat nerve pain/symptoms.

Minimally Invasive Procedures
We offer the following minimally invasive procedures:

• Spinal cord stimulation and peripheral nerve stimulation: Strategically implanted electrodes and a generator work together to send electrical impulses that block pain signals. 
• Radiofrequency ablation (RFA): Energy damages specific nerves so that they no longer send pain signals to your brain.
• Muscular activation: The ReActiv8 Implantable Neurostimulation System sends electrical pulses to nerves responsible for activating muscles that stabilize the lower back. This can improve chronic back pain.

Surgical Treatment Options
If other treatments can't provide adequate relief from the symptoms or pain related to your spine condition or if your condition is worsening, you may be a candidate for spine surgery. Depending on your condition, our spine specialists can offer various surgical options to address your individual problem. Duke’s spine surgeons perform:

• Disc replacements, spinal fusion, and laminectomies to correct spine problems
• Complex reconstructive surgeries to correct scoliosis and other spinal deformities
• Procedures to resect spine cancer and reconstruct the spine
• Decompression surgeries to relieve pain and pressure from pinched nerves
• And more

Whenever possible we use the least-invasive surgical techniques, so you recover quicker, experience less post-operative pain and fewer complications, and have smaller incisions. We’ll find the solution that’s best for you based on your activity goals, surgical preferences, and pain level.

We also offer "awake spine surgery" as an alternative for people who can’t tolerate or don’t want general anesthesia. Benefits include a shorter hospital stay and an easier recovery.

Learn if awake spine surgery could be right for you.

Diverse Team of Experts
Our team of spine specialists includes neurosurgeons, orthopedic surgeons, physiatrists, chiropractors, spinal oncologists, pain management doctors, physical and occupational therapists, psychologists, social workers, and many others. We work together to find the best treatment options for your unique symptom profile and lifestyle.

Measured Approach to Pain Treatment
We aim to find and treat the source of your pain, rather than just covering it up. We weigh the risks and benefits of every treatment option and follow strict guidelines, especially when considering prescribing medications with a risk of dependency. We take seriously our responsibility to care for your current and future wellbeing.

Duke Spine Health Program
Our Spine Health Program makes it easier to start with conservative options like chiropractic care, physical therapy, acupuncture, massage, yoga, mindfulness, and more. With in-person or virtual visit options, we help you learn about your back or neck pain and manage it at home so you can feel better and stay better. 

Highly Experienced Spine Center
Research shows that hospitals and surgeons who perform more surgeries tend to have better outcomes. Our surgical team performs more than 3,000 spine surgeries every year and sees over 30,000 patients. 

Safe, Effective Results
Our surgeons are motivated to constantly improve, so they pay close attention to outcomes and always strive to do better. All three Duke hospitals have been named Blue Distinction Centers+ by Blue Cross Blue Shield. This recognizes Duke’s delivery of safe, cost-effective, and efficient spine surgery care. As members and leaders in the American Association of Neurological Surgeons, American Academy of Orthopaedic Surgeons, Scoliosis Research Society, North American Spine Society, and Cervical Spine Research Society, our spine surgeons stay up to date on the latest technologies and advances in treating your spinal injury or condition. This results in safe, effective procedures that reduce complications to your crucial but delicate spine, nerves, and spinal cord. 

Optimizing Health
For people recommended for spine surgery, we work diligently to optimize your health before, during, and afterward to ensure you achieve the best possible outcomes.

• Pre-rehabilitation with physical therapy programs helps evaluate, improve, and optimize health prior to surgery.
• Our Pre-Anesthesia Testing Center (also known as the PASS or Preoperative Anesthesia and Surgical Screening clinic), assesses your health and readiness for surgery that requires anesthesia.
• Our POSH (Perioperative Optimization of Senior Health) program implements risk-reduction strategies specifically for older people.
• Our POET (Perioperative Enhancement Team) assesses people with chronic diseases -- such as diabetes, heart disease, anemia, and osteoporosis -- and refers them for treatment before surgery to increase their chances of success.

Remote, Written Second Opinion Reports
Get a written second opinion report about your spine condition from a Duke Health specialist in the comfort of your home. A second opinion can confirm a diagnosis, offer a different diagnosis, provide information about the most advanced treatments available, and ensure confidence in your decisions when faced with a serious medical condition. Learn more about our remote second opinion platform and process.