Why do back surgeries fail?
All spine surgery carries with it a significant degree of patient risk but when the resulting surgery does not alleviate the problem, or creates even greater problems for the patient, the situation is referred to as a “failed back surgery syndrome (FBSS). Read More….
Back Surgery: What You Need to Know
Back surgery has been known for “leaving more tragic human wreckage in its wake than any other operation in history,” according to Gordon Waddell, MD, director of an orthopedic surgical clinic for over 20 years in Glasgow, Scotland.
“Low back pain has been a 20th century health care disaster,” said Waddell. “Medical care certainly has not solved the everyday symptom of low back pain and even may be reinforcing and exacerbating the problem.”
In 2010, researchers reviewed records from 1,450 patients in the Ohio Bureau of Workers’ Compensation database who had diagnoses of disc degeneration, disc herniation or radiculopathy, a nerve condition that causes tingling and weakness of the limbs. Half of the patients had surgery to fuse two or more vertebrae in the hopes of resolving their low back pain. The other half had no surgery, even though they had comparable diagnoses.
After two years, only 26 percent of those who had surgery had returned to work, compared to 67 percent of patients who did not have surgery. Of the lumbar fusion subjects, 36 percent had complications and 27 percent required another operation. Permanent disability rates were 11 percent for patients undergoing surgery, compared to only 2 percent for patients who did not undergo surgery. In what might be the most troubling finding, researchers determined there was a 41 percent increase in the use of painkillers, with 76 percent of surgery patients continuing opioid use after surgery. Seventeen surgical patients died by the end of the study.
The study provides clear evidence that for many patients, fusion surgeries designed to alleviate pain from degenerating discs do not work, according to the study’s lead author, Dr. Trang Nguyen, a researcher at the University of Cincinnati College of Medicine. His study concluded: “Lumbar fusion for the diagnoses of disc degeneration, disc herniation, and/or radiculopathy in a workers’ compensation setting is associated with a significant increase in disability, opiate use, prolonged work loss, and poor return-to-work status.”
Commenting on the procedure in general, Dr. Nguyen said, “The outcomes of this procedure for degenerative disc disease and disc herniation make it an unfortunate treatment choice.”
In 1994, the conducted the most thorough investigation into acute low back pain in adults and came to the following conclusion in its Patient Guide: “Even having a lot of back pain does not by itself mean you need surgery. Surgery has been found to be helpful in only 1 in 100 cases of low back pain problems. In some people, surgery can even cause more problems. This is especially true if your only symptom is back pain.”
In his 2009 article, “Overtreating Chronic Back Pain: Time to Back Off?” Dr. Deyo speaks of the shortcomings of medical spine treatments in the U.S.: “Jumps in imaging, opioid prescriptions, injections, and fusion surgery might be justified if there were substantial improvements in patient outcomes. Even in successful trials of these treatments, though, most patients continue to experience some pain and dysfunction. Prescribing yet more imaging, opioids, injections, and operations is not likely to improve outcomes for patients with chronic back pain. We must rethink chronic back pain at fundamental levels.”
Dr. Deyo is not alone in his call for reform in spine care. The editors of The Back Letter, a newsletter from the Department of Orthopedic Surgery at Georgetown Medical Center in Washington, D.C., agreed with his frustration:
“The world of spinal medicine, unfortunately, is producing patients with failed back surgery syndrome at an alarming rate … There is growing frustration over the lack of progress in the surgical treatment of degenerative disc disease. Despite a steady stream of technological innovations over the past 15 years – from pedical screws to fusion cages to artificial discs – there is little evidence that patient outcomes have improved … Many would like to see an entirely new research effort in this area, to see whether degenerative disc disease and/or discogenic pain are actually diagnosable and treatable conditions.”
Back pain can seem to take over your life. Your every thought and action is centred around your back. Patients come to me in pain, desperate to know whether Spinal Decompression is right for them. To help answer this question, Web MD has put together a useful guide about Spinal Decompression. Read more to find out whether Spinal Decompression might be right for you…
Sleeping With Spinal Stenosis, Sciatica Pain And Disc Herniation
Sleeping on your side (side sleeping) will be the suggested position for correct spine alignment. Coincidentally, sleeping in this position can result in other issues, particularly given lower back Pain and Pain related to sciatica, herniated discs, along with other sciatic nerve irritations.
When sleeping on your side, usually the upper leg will drift throughout sleep, moving forward and when unsupported by the lower leg, roll forward and down. To be able to accomplish this position, the pelvis should rotate in a twisting motion. This twist locations strain and stressors on the spine sacroiliac joint. The twists impact the lower vertebrae and discs. It not surprising that this can produce Pain and Pain within the lower lumbar region (lower back) and also the thoracic region of the back (middle back). The muscles inside your back tighten when stressed like this, and stretch the spinal ligaments.
Lower back issues like sciatica and sciatic nerve Pain, particularly from herniated discs and/or spinal stenosis, could be significantly aggravated. The objective would be to preserve correct positioning whilst within the side sleeper position. This could be accomplished by placing a leg pillow or cushion in between the mid-thigh to knee region, to encourage maintenance of the suggested position all through the night. Picture the correct alignment of your legs together with your spine. The spine is on a horizontal plane when both legs are extended symmetrically from the body. The support pillow ought to preserve the correct height and spacing of the legs, but also make sure the legs remain put and don’t drift forward, making the unwanted “twisting” stressors.
This generally causes Pain within the lower back or Pain that radiates via the buttocks and down into the legs. This may also create an intermittent shooting Pain. Sciatic Pain might extend all of the method to the feet, frequently dependent on corresponding nerves within the spinal column. Interestingly, sciatic Pain generally affects only 1 side of the body at a time.
Your back consists of a column of individual bones - or vertebrae - separated by small cushions - known as discs. These discs serve as shock-absorbing pads and are located between each vertebra.
When a disc is strained beyond its limit, the outer casing may bulge or rupture. The jelly-like inner substance can be squeezed or pushed out to the side or back and touch or put pressure on one of the spinal nerves. This is commonly called a disc protrusion, also known as a herniated disc or a ruptured disc.
