Back Pain Cure: Will Back Surgery Cure My Back Pain?

Back pain treatment ranges from conservative care to surgical intervention. Back surgery is required in less than 10% of patients suffering with low back pan. There are four reasons why surgery would be considered as a treatment option for patients suffering with back pain.

These include:

1. Intolerable or intractable back pain associated with a clear anatomical abnormality (herniated disc, spondylolisthesis).
2. Progressive changes in nerve function (changes in reflexes, muscle strength patterns, and nerve tension signs) that can be attributed to a clear anatomical abnormality.
3. Spinal cord compression (bowel and bladder changes, saddle area numbness, weakness in both legs).
4. Failure of conservative measures - provided there is a clear anatomical cause for the pain.

Of the four, spinal cord compression is a true medical emergency and requires immediate surgical evaluation.

Three back surgery procedures will be considered in this discussion: discectomy, decompression, and fusion.

Discectomy
The medical literature indicates that as much as 80% of the identifiable herniated discs that have associated lower extremity pain do not require surgery. Unless one of the four reasons cited above is present, disc herniation can most often be treated conservatively. If surgery is indicated, the procedure is fairly simple and straightforward. Although the term “discectomy” suggests the removal of the entire disc, the reality is that only the extruding portion of the disc is actually removed.

Decompression or Laminectomy
Sometimes, the bony elements of the spine can compromise the nerve structures and result in back and leg pain. These conditions are referred to as spinal stenosis. Surgical intervention is, therefore, aimed at removing the bony element, thereby decompressing the affected nerve element. Barring any surgical or post surgical complications, the success rate for this type of surgery is excellent. The procedure involves the removal of either the lamina (central portion of the bony covering of the nerves) or a reaming out of the opening through which the nerve exits the spine (foramen). The success rate for this type of surgery is fairly good at 88 percent in the first year and 70 percent overall.

Fusion
The goals of spinal fusion are to increase stability of the spinal element and to provide for and maintain an adequate opening for the nerve to exit the spine. Current techniques include bone grafts, screws, cage screws, and metal plating. Because of the smallness of the intervertebral disc in the cervical spine, fusion is almost always considered as an appropriate treatment choice and, as such, has an excellent success rate. On the other hand, national statistics for the success rate of spinal fusion for the treatment of non-specific low back pain is usually cited at 50 percent. The success rate for spinal fusion is much lower in patients who smoke.

Back surgery should always be the last back pain treatment option. The specific steps outlined in the Erase Your Back Pain program should be performed before considering back surgery. Even if you’ve had back surgery, the Erase Your Back Pain program will help you recover quickly. Get the details here: No More Back Pain!

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Dedicated To Erasing Your Back Pain,

Malton A. Schexneider, PT, MMSc
Clinical Specialist
Orthopaedic Physical Therapy