Back Surgery

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.

Surgery is also dangerous not only due to its many risks and the potential for operative and postoperative complications… No, surgery is a real hazard to some patients, since it excludes them from many other possible curative modalities which may have helped them, but are now out of reach because of the actual damage done to the spinal anatomy during the operation.

Back Surgery Operations

Back Surgery Procedures

Back Surgery Statistics

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 back 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.

Bottom Line on Back Surgery

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 5/23/06 Revised 2/3/12