In speaking with orthopaedic spine surgeons and neurosurgeons around the country, only about 10% of back pain sufferers will require surgery. Meaning 90% of people suffering with back pain can be helped with conservative measures. Despite this fact, however, the “surgery question” still comes up.
In this article, we look at what physicians say about the use of surgery to resolve back pain. We’ll also provide information and materials that will help you understand a little better the type of surgical options available.
When Is Back Surgery Necessary?
About.com contributing author, Jonathan Cluett, M.D., offers some advice about back surgery.
Usually a step when extensive efforts at conservative back pain treatment fails to relieve symptoms. Read on to learn about different types of spine surgery and the types of back pain these treatments may help.
My advice for people who are not finding relief is this: First, find a physician (orthopedist or general internist) you are comfortable and confident with, and work with him or her for at minimum several months–too many people jump from physician to physician and miss out on a complete evaluation. Second, you have to understand that back pain is often not a quick or easy fix. A dedicated approach to physical therapy and exercises often will alleviate back pain. If you’re unwilling to perform exercises, your treatment may be less satisfactory. Finally, don’t give up–there’s usually more that can be done in the treatment of back pain.
Spine surgery is rarely an initial treatment for back pain, however, there are a few emergencies that may require surgical treatment. In the vast majority of patients, spine surgery is only considered after a long course of conservative therapy. As stated earlier, back pain often takes quite some time to resolve. Therefore, rushing into spine surgery may not be the best idea. Most commonly, doctors will advise at least 3 to 6 months of conservative treatment before considering spine surgery.
Spine Surgery Options
A discectomy is a procedure to remove a portion of the disc that rests between each vertebrae. A herniated disc is the most common reason for spine surgery. In this type of spine surgery, the herniated disc is removed and relieve the pressure on the nerves.
A foramenotomy is also a procedure used to relieve pressure on a nerve, but in this case, the nerve is being pinched by more than just herniated disc. A foramenotomy removes a portion of bone and other tissue that may be compressing the nerve as it exits the spinal column.
A laminectomy is done to relieve pressure on the spinal cord itself. A laminectomy is most commonly used to treat conditions such as spinal stenosis and spondylolisthesis. Depending on the amount of bone removed, this procedure may be done with a spinal fusion to prevent instability.
A spine fusion is surgery that is done to eliminate motion between adjacent vertebrae. The spine fusion may be done because to treat a problem such as spondylolisthesis (unstable spine), or it may be done because of the extent of other surgery (such as a laminectomy).
Spinal Disc Replacement
Spinal disc replacement is a new surgery that is still quite uncommon. Spine disc replacement is done to treat specific types of back pain, while avoiding the problems associated with spine fusion surgery.(Read the full article here)
Can Surgery Help Back Pain? (Video)
Here’s an interview with neurosurgeon, Dr. Carter Beck where he discusses surgical intervention to treat back pain.
As you learned in this interview, surgery IS NOT necessarily the first or best alternative in managing back pain. As a rule, surgery is considered as a last resort and, even then, only if these 4 factors are met:
- Intractable pain – meaning the pain never changes in frequeny or intensity.
- All conservative measures have failed.
- Changes in neurological status such as strength loss and changes in reflexes.
- True medical emergency such as a spinal tumor or spinal cord compression.
Do you have a question about surgery to resolve your back pain, neck pain, or sciatica? Perhaps your doctor has recommended surgery and you’d like more information about the particular procedure he or she would use. We have specific Patient Guides that discuss in detail the various surgical options available for the treatment of back pain. Topics such as discectomy, spinal fusion, leminectomy for the neck and low back are but a few of the topics discussed.
If you would like access to these comprehensive Patient Guides, just click this link and we’ll make sure you get your copy today. Patients’ Guide To Spine Surgery
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