Spine Surgery: The Last Resort

Surgical Patient with Doctor in the BackroundBack surgery is usually an elective surgery. The exception is when there is an emergency or rare condition such as a tumor, infection, cauda equina syndrome, or trauma that causes damage to the spinal cord. But these situations are truly rare. Generally, it is up to you and your doctor to determine whether or not back surgery is the right choice for your particular condition.

Most back surgery is done to relieve pressure from the nerve or stabilize a segment of the spine. Diagnostic tests will confirm whether a particular root is at fault. The causes of pinched nerves are many, including vertebral fractures, bulging discs, or bone spurs, just to name a few. Different reasons, different surgical options.

To follow are among the most commonly performed back surgeries. Surgeons who perform them are either neurosurgeons (specializing in the nervous system) or orthopedic surgeons (those who specialize in bones), ideally ones who focus on the spine instead of general orthopedics.

Back Surgery Is No Guarantee
Statistics show that many back surgeries successfully reduce or eliminate pain as intended. However, failure rates can be anywhere from 10 to 40 percent. In medical parlance, it's called failed back-surgery syndrome (FBSS). In those cases, patients may undergo yet another procedure or try a different approach. Back surgeries can fail for many reasons. Problems can include scar tissue, instability issues caused by some decompressions, or unrealistic expectations of what the surgery could fix. The biggest contributor to FBSS is persistent pain.

Watch Your Back
Failed back-surgery syndrome is the term used when patients continue to experience pain after the surgery. According to research from the National Institutes of Health, the incidence of failed back surgery syndrome is about 40 percent.

Elective Spine Surgery
With an elective procedure, you have time to research. Consider your options, realistically understand the potential outcomes, and evaluate surgeons very carefully. A qualified surgeon should be doing at least 100 cases per year. He or she should also be able to answer all your questions candidly and thoroughly and shed light on what to expect after surgery.

Second Opinion
Also know that good surgeons are not intimidated when you want to get a second opinion. In fact, many recommend it. Of course, all surgeries carry some risk. Ask about both risks and benefits. And be wary of anyone who promises to relieve all of your pain.

The Least You Need to Know

  • Unless there is a medical emergency, back surgery is an elective procedure.
  • Back surgery is generally done to release trapped nerves that cause pain.
  • A variety of back surgeries are performed, but each basically does one of the following: decompresses, stabilizes, and repairs fractures.
  • Some people need more than one type of procedure.
  • Post-op care and therapy are crucial for proper healing and continued back health.

Jason Highsmith, MD is a practicing neurosurgeon in Charleston, NC and the author of The Complete Idiot's Guide to Back Pain. Click here for more information about the book.

Updated on: 10/27/15
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