Spine surgery can be divided in two broad categories: spine decompression surgery and spine instrumentation/ fusion surgery (mostly accompanied by spine decompression). A spine decompression surgery involves releasing pressure on the spinal cord, whereas in spine instrumentation surgery this is accompanied by instrumenting the spine using screws/ plate/ rod/ cage system. These are called spine implants.
In majority of the cases, especially in lower back, only a spine decompression surgery is usually required. However, there are certain situations in which spine instrumentation becomes necessary. Spine instrumentation is done to fix the spine in a particular position and to help instrumented bones fuse/ unite with one another using bone graft material for long term success.
In following situations a spine instrumentation surgery is required:
Even though for majority of spinal problems there is consensus among spine specialists whether spine instrumentation is required or not for a particular case, there are situations where one spine doctor might recommend spine instrumentation surgery, whereas other will recommend a spine decompression surgery only. This happens due to difference in trainings, practice experiences and belief between different spine specialists.
One of the biggest advantage of spine instrumentation is as instrumented part of spine will not move any more, there is no possibility of further wear and tear at that level which can cause recurrence of symptoms in future at that particular level.
However, there are certain drawbacks of spine instrumentation surgery (though you have no option other than doing an instrumentation surgery in certain cases).