by David Greene, MD, CEO
Every year, a few hundred thousand low back operations happen in America. Overall the successful results from these operations depends on the reason for the operation along with the technical skill of it being performed.
How can a back operation be avoided and how is an individual to know if he or she is in the category of having the choice to successfully opt out of surgery and have it not be harmful in the future?
The initial thing to understand is what is the pain generating diagnosis. Most commonly they include:
1. Degenerative Disc Disease
2. Herniated Lumbar Disk
3. Degenerative Spondylolisthesis
4. Degenerative Arthritis
5. Vertebral Compression Fracture
Once the person has the diagnosis established, it may be placed into either a 1) Elective quality of life issue or 2) Surgical Indication exists
Let's look first at Degenerative Disc Disease, which often occurs in patients between the ages of 30 and 60. Degenerative discs do not always result in pain, there is actually a significant portion of the population who has DDD noticeable on MRI but no back pain at all. In some patients, though, it may cause significant back pain and lost time from work.
DDD is not a disease that needs an operation, it turns into an elective decision. Success rates for DDD fusion surgeries are fifty to seventy percent and a lot of patients end up needing more surgery in the future and more pain medication. Nonoperative treatment for DDD may help substantially including NSAIDS, acetaminophen, chiropractic, aerobic exercise, and pain management.
Most low back pain problems are quality of life decisions. If considerable nonoperative therapy doesn't work, then an operation can be undergone electively. A lumbar pinched nerve is often in this category when it is resulting in numbness or pain. If an individual can handle the pain, research shows that the outcomes with an operation vs nonsurgical treatments are the same after one year.
If muscle weakness is present such as a foot drop, then surgery may be indicated. With a neurologic deficit, then the longer one waits to undergo an operation the chances are it will not improve even if the operation is done perfectly.
This is exactly the point with spinal arthritis. No one ever died as a result of arthritis. So if arthritis causes degeneration or a spondylolisthesis along with spinal stenosis and there's no muscle weakness from pinched nerves, the situation is elective. Opting for surgery is fine if conservative treatment has been exhausted, there is a surgery for the specific condition with a successful track record, and the patient is healthy enough to undergo it. But if the condition is in fact elective, patients need to weigh the pros and cons considerably to make sure they are comfortable with the potential for a poor outcome compared to the potential for marginal improvement with nonsurgical treatments.
These can include spinal decompression, PT, chiropractic, and pain management.
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New Unique Article!
Title: When Can Back Surgery Be Avoided?
Author: David Greene, MD, CEO
Email: daveman96@aol.com
Keywords: back pain,pain management,spine surgery,spine,arthritis,medicine,disease,health
Word Count: 478
Category: Medicine
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