Alternatives to surgery are physical therapy, medications and injections, if needed. If you have a disc herniation, canal stenosis or significant impingement, surgery would be beneficial. Surgery has its own risks and complications like any other surgery, so one should weigh the risks and benefits before going for surgery.
If your symptoms are severe enough (disturbing your daily activities) and once you have exhausted conservative treatment for at least 6 months, then your only choice would be surgery. The type of surgery and implants used would be surgeon dependent.