Do I Need Back Surgery?

Back Surgery

Back surgery has been a popular treatment for back pain since the dawn of the modern medical age. The science of spinal surgery has improved greatly over the last few decades, offering more procedural options with less risk factors.

Modern spinal procedures are much more effective and less invasive than operations performed in the past.

Orthopedic surgeons and neurosurgeons have become increasingly specialized in certain surgical procedures and it is now easy to find an expert for almost any type of surgical intervention.

It must be noted that patients are advised to seek out doctors who focus on their chosen surgical technique. A niche expert with a tremendous amount of real world experience performing a particular procedure will generally offer better results than a general surgeon who does a little bit of everything.

When it comes to a back surgeon, you do not want a jack-of-all-trades.

Back Surgery Operations

Back surgery is a topic of great dread for most chronic pain sufferers. Most of us have heard a variety of actual and/or exaggerated horror stories about the ravages of surgery and how so many patients never recover. It is very true that surgery is a drastic method of treating symptoms and should never be considered lightly.

However, in some cases, surgery may offer the best chances for permanent resolution of pain and a complete recovery. Unfortunately, these scenarios do not represent the situations faced by the average person who undergoes a spinal operation with great hopes, only to be disappointed with results.

Research statistics are clear that many procedures do not provide much hope for a cure. Furthermore, most back surgery procedures fail either immediately or eventually, with only a minority being considered successes over timelines of 7 years or more. This is a frightening statistic indeed.

Operations are also dangerous, not only due to their many risks and the potential for operative and postoperative complications, but also since surgery excludes some patients from attempting many other possible curative modalities.  These treatments may have helped, but are now out of reach because of the actual damage done to the spinal anatomy during the procedure.

Back Surgery Topics

Spinal surgery can be a real trial and that is when everything goes perfectly.  Patients are strongly advised to put in considerable research time before even thinking about agreeing to a surgical prescription.  The following studies provide a comprehensive education on surgical methods and results:

Discectomy is one of the most commonly performed of all spinal operations.  Meanwhile, the procedure is known for providing disappointing results, especially when measured over longer timelines.

Disc replacement surgery offers an enlightened alternative to spinal fusion, utilizing artificial discs to maintain natural functionality in the vertebral column.

Spinal implants come in many forms and serve many specific purposes, including the X-Stop and Coflex designs.

Foraminotomy can relieve neuroforaminal stenosis and free a compressed nerve root.

Nucleoplasty and IDET are effective minimally invasive approaches to disc surgery.   Intradiscal electrothermal therapy is best utilized when the disc to be treated remains structurally sound and fully intact.

Corpectomy removes one or more vertebral bones in order to decompress the central spinal canal or restore spinal stability.

Spinal fusion surgery, often simply called spinal fusion, is the most difficult operation to endure and also the riskiest.

Laminectomy is a multipurpose procedure that can be used to treat several common spinal issues alone or in combination with one another.

Cryoanalgesia uses cold technology to provide lasting nerve signal reduction.  Meanwhile, radiofrequency lesioning and various forms of neurotomy provide more traditional types of nerve ablation.

Vertebroplasty and kyphoplasty can be used to reconstruct damaged or fractured vertebrae using minimally invasive techniques.

Facet rhizotomy and other forms of rhizotomy are used to decrease pain signals by affecting the nerves that are thought to be involved.

Coccygectomy is becoming more commonplace as more patients seek treatment for tailbone pain syndromes.

Disc surgery remains the most common type of approach to surgical care within the back and neck pain treatment sector.

Laser spine surgery can reduce risks associated with some procedures and increase the precision of difficult operations.  Laser surgery on the back is now very popular, with more surgeons specializing in laser-assisted procedures.

Neck surgery always requires an expert touch, due to the sensitive proximity and small anatomical area to be treated.  

Cervical spine surgery should always be performed by a specialist and often benefits from more than one surgeon during the operation.

Minimally invasive surgery has become the rule of surgical treatment, rather than the exception.  Endoscopic spine surgery is just one technology that makes this possible.

Back pain surgery is specifically performed to minimize symptoms, rather than cure a particular diagnosis.

Spine surgery risks are substantial and should always be discussed prior to undergoing any operation.

Surgical complications are also commonplace and ruin postoperative results for many unfortunate patients.

Surgical nerve damage and  spinal surgery infection are two of the most commonly experienced complication of invasive back and neck treatment.

Spine surgery scar tissue can cause long-term consequences for postoperative patients.

Spinal surgery alternatives are nonsurgical treatments that allow patients to successfully avoid back surgery.

Recovering from surgery is a difficult and painful process for most patients.

Failed surgery syndrome is the saddest of all outcomes, when surgery does not relieve the pain and might even make it much worse.

Spine surgery placebo is an interesting and proven phenomenon wherein an operation is effective simply due to psychological effect, rather than actual efficacy.

Spinal surgery pain might endure for months or years after invasive surgical care.

Medical tourism surgery offers patients incentives to travel to receive invasive care in another area of the world.

Back Surgery Statistics

I have used the past decade writing this site to investigate and document thousands of particular cases of surgical intervention for back pain. I have compiled patient stories including their diagnosed conditions, chosen procedure, surgical approach, immediate post operative results and long-term recovery for the purpose of providing myself, my staff and my readers with a real look at how spinal surgery fares statistically.

I was hoping for some surprises; since I really do admittedly have a poor outlook on the surgical sector based on my on limited experience with operations and the experiences of those around me. I was really thinking that maybe things will get better and this research will show some hope that patients are doing better than I thought.

Well, nothing has changed and I am just as disgusted now as ever. Here are some quick thoughts regarding spinal procedures, based on tens of thousands of cases documented by myself and my company, SAR Research and Statistics Ltd:

Discectomies are some of the least successful long-term, being that most herniations recur or occur in a neighboring level. True cures from discectomy rank very low on the rating scale. This is discouraging, since this is also the most common procedure all around in the study.

Spinal fusions generally rank abysmally, with a great number of patients being worse immediately after surgery and even more so over time, both symptomatically and functionally. Fusion also excludes patients from many potentially effective exercise therapies and some conservative care measures, such as spinal decompression. However, fusion also does seem to provide good results for a minority of patients who report years or even decades of good health afterwards. This is not typical, but does sway the stats a bit. Complications with fusion are the greatest, with unsuccessful vertebral joining very commonplace and hardware-related complications being the worst in their effects.

Minimally invasive techniques are better tolerated, heal faster and improve long-term results better than fully open techniques, regardless of which procedure is used. This is no surprise.

Foraminotomies and laminectomies suffer from the most cases of scar tissue buildup cited as contributory to ongoing pain by the operating surgeon.

Artificial disc replacement procedures actually degenerated in their results over the years with many more patients reporting good results 5 years back compared to now. Maybe expectations are higher or less qualified surgeons have taken to offering this technique. Whatever the reason, I am disheartened, since this seemed like a great alternative to the often ridiculous notion of fusion.

One of the highest satisfaction ratings comes surprisingly from coccyx removal. This really should not be such of a shock, since it seems many coccyx pain conditions may be TMS and the surgery may act as a terrific placebo cure. The question remains, how many of these patients may have developed chronic pain somewhere else.

The most common reason for back surgery is disc pathologies and these are also the spinal conditions least often to be successfully resolved, given a timeline of 7 years, regardless of the procedure utilized.

It is clear that spine surgery results often do not live up to expectations, due to potential misdiagnosis of the actual problem causing the pain, complications or poor surgical technique. This is why I advise patients to be 101% sure that an operation is right for them before getting it done.

When it comes to surgery, 99% sure is not enough. Do your due diligence and learn the facts from multiple sources. I really wonder how the surgical aspect of the back pain industry can be so well established with such abysmal curative results. Before even considering surgical intervention, please read my article detailing spine surgery barbarism.

I will spare all of you that true tales of terror that I have collected, but let it be known that they are numerous and truly bone chilling. I have seen it all when it comes to surgical nightmares, all perpetrated against normal people like you and me, who just wanted a cure for their pain.

Is this too much to ask?

Well, in these cases, apparently it was. They suffered terribly and most continue to suffer to this day. To all of you unnamed here, you are not forgotten and your stories have done much to help others find a better path to a cure.

Surgery on the lower back is the most common type of spinal operation.  Read all the facts before committing to any procedural choice.

Back Surgery Outcomes

I had been told by several doctors that I was a good surgical candidate from very early in my back pain journey. One doctor in particular told me that I would never get better without surgical correction, since my back had deteriorated so much. He also predicted dire health consequences for me, including possible paralysis, if I did not acquiesce to his suggestion. Trust me, I have heard all the scare tactics used by some less scrupulous surgeons.

I have also heard many dire predictions which were true and surgery turned out to be good advice, so once again, this can be a very confusing time with patients not knowing whom to believe.

Spinal surgery should be a last resort as a treatment for back pain whenever possible. Surgery has inherent risks from anesthetic and infection and the outcome is not always (or even often) successful. Many patients receiving surgery for back pain end up in worse condition after their operation than before.

Some patients are free of their pain, but have been severely restricted in their movement and activity level for the remainder of their lives.

There have been many cases of surgical correction fixing a back problem in one area of the spine, just to have the same or a related problem occur in a different area.

I would strongly caution against back surgery in all but the most extreme of cases without considerable forethought and a tremendous amount of concerted research.

A final thought to remember:

Back surgery can always be done, but it can never be undone.

Back Pain > Back Surgery