Back Surgery Negative Side?

Excessive Surgeries

Do You Need Back Surgery?

Good Situation for Surgery is…

Bad Situation for surgery is…

There was a time when doctors commonly recommended surgery for back pain. More recently many doctors are starting to recommend surgery as the last option when all other mainstream home remedies or professional treatments have failed. (See the two full sections on these treatments for more information. They are called Mainstream Professional Remedies and Mainstream Methods to Cure Your Back by Yourself .)

Even when surgery is used as the final option, it does have its pros and cons. While it can help permanently or temporarily resolve the issue, there can be drawbacks and side effects. Some of these “cons” to back surgery are discussed in the next chapter, “Back Surgery Negative Side?”

Back Surgery Negative Side?
Of course, having back surgery isn’t necessarily a bad thing, but a prospective back surgery patient should always weigh the bad things against the good.

1. While surgery to relieve pain due to damaged nerve endings can successfully block the pain, these procedures can be extremely invasive and the results are not always permanent. When the pain returns, the procedure may need to be done again.

2. Surgery like a spinal fusion can put a stop to the motion in your back and the instability of the spine that causes pain. But spinal fusion can also result in the spine being less flexible. It may be necessary to learn how to move differently in order to compensate for the inhibited motion.

3. Spinal surgery can relieve pain, thus making it possible for a patient to take part in a physical therapy program that they other wise could not have been able to do. However, no doctor can guarantee that it will work. For some patients surgery will work and others will have a little change in their symptoms. But there are those patients who experience even more pain after surgery.

4. Some people opt for more aggressive treatment like spinal fusion for their back pain so that they can get back to their normal activities more quickly than less aggressive treatments like exercise, physical therapy, acupuncture, and chiropractic can have.

The other side of that is that surgery requires considerable time to recover and does have side effects. One of these side effects is that the segment that is fused can cause stress on the parts of the spine above and below it. This is referred to as “adjacent segment disease” and it can result in degeneration in these segments.

5. Since surgery like spinal fusion involves a lot of bone work, there will likely be more pain for a while and a long recovery time. The facet joints and transverse processes are exposed during a fusion which means muscles must be dissected during the surgery. Inflammation can develop as a result of the bone grafts or substitutes that are inserted in the spine to help with the fusion. Inflammation leads to scarring and pain.

6. Any surgery makes scar tissue. When your body heals, that scar tissue can build up so much that it may begin to touch on a nerve and cause the same amount of pain that you had when the degenerated disc was applying pressure to that nerve.

7. Quite often the long-term prognosis after spinal surgery is no better than that when less invasive treatments are used.

8. More mainstream treatments are much less costly than surgery.

A survey conducted among recipients of back surgery showed that over 50 percent of them had at least one problem or complication after the surgery.

Excessive Surgeries

Even thought the evidence shows that most back pain will either go away on its own or with the help of mainstream treatments like physical therapy, exercise and stretching, and chiropractic, back surgery is on the rise. In fact, a 2007 study had back surgery at the top of a list of most overused tests and treatments.

One example of this is the switch from surgical decompression to treat spinal stenosis to spinal fusion. In fact the number of spinal fusions increased 15 times in a five-year period among Medicare patients. Spinal fusion is much more invasive that decompression and there is not as much proof that it works as there is for surgical decompression.

Research into this increase in invasive and expensive surgical procedures suggests that one of the reasons for it is because of all the new innovations and devices. These new techniques may tend to influence the opinions of the leaders in this field to the point that they recommend surgery just to try out these innovations. There is also the matter of financial incentives for surgeons and hospitals.

Do You Need Back Surgery?

There are times when surgery is the only reasonable option. But that decision is yours, not your doctors. These days patients more actively participate in the decisions made for the treatment of their back pain. Because each patient has the ultimate say as to whether or not to have back surgery, it is their responsibility to look a the pros and cons closely, the possible risk and benefits, and what the chances are that the surgery will actually be successful in relieving their pain.

As a potential back surgery patient, you need to be absolutely confident in your decision. When you go into surgery with a positive attitude, goals that are realistic to achieve, and complete understanding of what the surgery will accomplish this can actually make recovery from the surgery easier.

But how do you achieve this positive attitude? Learn everything you possibly can about the procedure and how it is performed and statistics about possible outcomes. Ask your doctor a lot of questions and have him or her point you towards all the information you can get your hands on before making your decision. The survey mentioned in “Back Surgery Negative Side” showed that one quarter of the people questioned had not been informed by their doctor of the risks of the surgery like bleeding, infection, and nerve injury.

Another thing that can be important in determining if you need back surgery is a second opinion from another physician. You don’t need to change doctors completely. Make an appointment with another spinal specialist and get another diagnosis and treatment recommendation. The best way to get the most honest answer from this second opinion is not to tell this physician what the first doctor has diagnosed and recommended as treatment. Doctors will often tend to agree with the judgment of the first doctor.

If you feel good about your decision to have surgery after doing all of these things, then you have probably made the right choice.

Good Situation for Surgery is…
There are a lot of cases that make back surgery appropriate.

1. Most spine physicians will find surgery to be appropriate when more conservative measures have been ineffective, the cause and source of the pain has been clearly identified, and there is a specific surgical procedure for the condition that has a high success rate and low rate of complications.

2. When symptoms of spine problems become disabling to the patient to the point where he or she is not able to perform their normal daily activities spine surgery can be appropriate.

3. Surgery is appropriate when there has been on-going nerve loss. This nerve loss can result in weakness that causes foot drop or bladder or bowel dysfunction. In some of these cases surgery may need to be done on an emergency basis.

4. Some rare conditions that require surgery are spinal infections that can cause destruction of the vertebrae, unstable fractures, and tumors.

5. Spinal cord trauma that results in injury to spine may require surgery. This type of trauma can be caused by things like car accidents, falls, and sports related injuries. Surgery may be needed to remove tissue or fluid that is pressing on the spinal cord, to remove fragments of bone or disc, or to stabilize a fractured vertebra.

Bad Situation for Surgery is…
Back surgery should always be considered the last resort after the mainstream treatments have been exhausted with no relief. Normally, 90 percent of back pain will heal with less aggressive, non-surgical treatments or with time. While back surgery can be very effective for a lot of cases of pain, it is not appropriate for most of the more typical and less severe conditions that can produce back pain.

A specific example of when surgery may not be appropriate is the case of a herniated disc where the part of the disc that is pressing on the nerve and causing the pain is removed. (For more information on this type of surgery, see the chapter called Latest Advances in Spine Surgery .) While this surgery does work to relieve the pain, it does not treat the underlying cause of the herniation.

Herniated discs usually result when there are muscle imbalances and postural problems that are causing the back to weaken. If these issues are left untreated, it is possible that after having a herniation repaired, the spine can continue to degenerate and in time the pain will come again. Surgery does not treat muscle imbalances.

In this case it is also true that the recovery from the surgery itself can cause further problems. While the body is recovering there can be severe pain. This pain can cause the body to move awkwardly and contort. This can result in additional stress on the body, especially in the areas above and below the surgery as well as in other joints like the hips and sacroiliac.

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