When is Spine Surgery the Next Right Step?

For anyone who has suffered from back pain and especially for those whose pain is considered chronic (pain that has persisted for three months or longer), there are numerous possible treatment “options” abound—some even boasting the promise to “cure” or offer lasting relief. From gadgets peddled on the Internet, activities or exercises suggested by well-meaning friends and loved ones and yes, even those treatments recommended by health care providers, there is no shortage of ways to approach back pain management.

As a spine surgeon, I am often the final few steps on a patient’s journey to find lasting back pain relief. Depending on where the road has taken them, I sometimes encounter a weary and wary traveler who is still in significant pain. He or she knows that just “living with the pain” is no longer an option—perhaps due to disability, disfigurement or lifestyle accommodations so severe that life with pain no longer seems livable.

man's feet facing arrows pointing left and right

For one reason or another, the public has been conditioned to see consideration of spine surgery as an “easy way out” of back pain. I’m here to tell you that nothing can be further from the truth. Spine surgery is neither easy nor without risk and sometimes it fails to eliminate the pain. But over the course of my career, I’ve also seen it provide renewed hope and restored life to so many people afflicted with a wide range of degenerative spinal diseases or traumatic spine injuries. Is spine surgery for everyone? No. Consideration for any type of surgery must consider the individual human-being who will be undergoing it. And depending on the condition attempting to be corrected with spine surgery, a number of other factors must be evaluated.

In cases that don’t involve a traumatic spine injury (surgical consideration for some of these types of injuries is evaluated differently), back surgery is typically considered when a concerted attempt at more conservative treatment options has failed to provide adequate relief from the pain. Conservative treatment options may include physical therapy, epidural steroid injections, chiropractic treatments and medication therapy, to name a few. No matter the cause, persistent (chronic) pain is the most common denominator in whether spine surgery should be considered. Other factors include disability (perhaps the condition has become so severe that the patient is wheelchair-bound) and disfigurement (in cases of scoliosis or kyphosis, for example).

I’ve written it in many an article before, but it bears repeating—not all spine surgery types are considered equal, nor are the surgeons who perform them. In situations where surgical treatment of a spine condition can be corrected using a minimally invasive approach, it’s an option worth exploring. Studies have shown that minimally invasive spine surgery can reduce operative risk as well as shorten recovery times for many patients. Likewise, it’s important to find a spine surgeon who is willing to openly discuss treatment options with you (including honest disclosure about their risks) as well as one who has the skill and expertise necessary in treating your specific condition. But perhaps most importantly, you must feel comfortable in discussing, accepting and following the recommendations your spine surgeon makes. No matter the path to spine surgery you’re on, trust is a necessary guide post to get you to your (hopefully pain-free) destination. 

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