cause some degeneration as well. Finally, surgery for herniated disks is no better than non-surgical treatment over the long term, according to the Johns Hopkins report.
Unless you’re seeking emergency surgery, you have time to think things over and get a second option. Among other things, you should realize that back surgery isn’t always successful. Spinal fusion is successful up to 80 percent of the time, and surgery on your disks will eliminate pain and sciatica in 70 percent of cases, according to the Johns Hopkins report.
According to a report in the Journal of Neurosurgery, success rates for microdiscectomy (measured by pain relief and patient satisfaction) reach 75 to 80 percent. However, you may be among the minority whose back pain is still there after the operation. It’s a combination of how you were selected for the surgery, and the skill of the surgeon, plus a touch of luck.
Ironically, while back surgery has given many people a new lease on life, it has sent others into a cycle of pain and frustration, Deyo says. In Deyo’s view, doctors are sometimes too quick to recommend surgery for patients with aching backs. Some patients end up having unnecessary operations that do nothing to relieve their pain, and a few leave the operating room worse off than they were before, he says.
Can you make it through a difficult recovery period?
Even if everything goes according to plan, the recovery process can be grueling, especially for patients who undergo spinal fusion. According to the North American Spine Society, healthy, young patients who have a simple fusion must severely limit their activities for 4 to 6 weeks. An older person with more extensive surgery could easily be laid up much longer. Although you shouldn’t stay in bed, you’ll likely have to avoid driving, lifting, and bending forward — even too much sitting.
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Unproven procedures
Despite the shaky evidence, many patients with simple back pain continue to go under the knife. For example, a minority of surgeons perform spinal fusions on patients who have no symptoms other than back pain. The operation is based on the theory that old or weak disks can hurt whenever the vertebrae move. By stopping the movement, surgeons hope to stop the pain.
Unfortunately, this approach is plagued with uncertainty. According to a report from the North American Spine Society, surgeons have no way to pinpoint the exact source of so-called disk pain. More importantly, there is no proof that patients who undergo the procedure for back pain do any better than patients who take a more conservative approach. “People who have spinal fusion surgery often feel better, just as people who go to the YMCA often feel better,” Deyo says. “The truth of the matter is that most people improve eventually on their own.”
Like the Johns Hopkins report, the North American Spine Society says spinal fusion surgery should be an absolute last resort for patients with simple back pain. In other words, if you have back pain without serious complications, try everything else first. With gentle activities, pain relievers, ice packs, heating pads, and a little time, your back is almost sure to feel better. If the pain doesn’t go away and your doctor recommends spinal fusion surgery, find out why he or she thinks the surgery might help, and ask for a second opinion if necessary.
In short, back pain may be miserable and aggravating, even agonizing, but it’s rarely an emergency. You have the time to work with your doctor (or several doctors) to find the treatment that’s right for you. Back surgery could very well be the answer. Just make sure you’re asking the right questions.