Do you know anyone who has ever had back or neck surgery? Did it work? There is a likely chance that it didn’t. Only 20% of spinal surgeries are successful. That is a risky choice for a procedure that seems likely to fail. Is there a better solution to treat pain? In this week’s blog, we will talk about why patients choose spinal surgery, discuss common spinal surgical procedures, and analyze what could have been done better to help patients.
Why Do Patients Get Spinal Surgery?
When patients choose the medical route for spinal pain management, they go down a vicious cycle. Patients start the cycle by meeting with their primary care physician. From there, they begin the cycle by starting treatments with medications, performing physical therapy, obtaining a referral to a specialist, undergoing diagnostic imaging, seeing an orthopedist for injections, seeking surgery, meeting with a neurologist, having a possible 2nd surgery, and then meeting with pain management in that chronological order.
This list of treatments can take place in a matter of 3-6 months. In more severe cases that occur suddenly, doctors may skip the least invasive procedures, and jump right to epidural injections and surgery. Research shows that repeat spinal procedures have an 80% likelihood of occurring.
So, why do patients get spinal surgery if successful treatment is debatable? Patients want opinions from medical doctors. Medical doctors recommend surgery based upon the skills they learned in school and clinical judgement based on neurological findings and failed treatments through the vicious cycle.
What Are Some Common Spinal Surgeries?
There are several different types of spinal surgeries to treat pain, but the three most common are spinal fusions, a laminectomy, and a discectomy. Below is a description of each.
- Spinal Fusion
A spinal fusion involves removing the spinal disk between two or more vertebrae and then fusing the adjacent vertebrae using bone grafts or metal devices secured by screws. A spinal fusion results in restricted range of motion and flexibility. Once a fusion is performed, the surgery is permanent and cannot be reversed.
The purpose of a spinal fusion is to eliminate motion between vertebrae. It also prevents the stretching of nerves and surrounding ligaments and muscles. It is an option when motion is the source of pain. This is commonly seen in patients with arthritis or degenerative disc disease.
The downside of a spinal fusion is that it doesn’t seem to be very effective with pain management or reduction in degenerative vertebrae. Pain from arthritic changes continues to be problematic after surgery.
The lamina is the arch-like feature on the back side of the vertebrae that attach to the bony prominence, the spinal process, which are the little bumps that we can feel down the central region of the back. A laminectomy is when these arch supports and spinous process are removed from a vertebra to help create more space for an injured disk.
The downside of a laminectomy is that it doesn’t fix the bulging or herniated disc. A laminectomy makes the space wider for a damaged disk to grow larger. Eventually, the disk has the potential to outgrow the space, and previous symptoms will return.
A laminectomy is trouble waiting to happen because now, the disk is worse than when symptoms happened pre-surgery. The likelihood of pain returning after a laminectomy procedure is greater than successful treatment.
A discectomy is the most common type of spinal surgery performed in the United States. A discectomy is when an injured part of a spinal disk is removed. The entire disk is not removed like a spinal fusion.
The downside of a discectomy is that a repaired disk can be reinjured, due to repetitive motion, trauma, obesity, or aging factors. A laminectomy and discectomy are usually done together, but not always. If a disk is reinjured, the surgeon may suggest a spinal fusion.
Spinal Surgery Risk Factors
Besides the high chance of an unsuccessful procedure, spinal surgery comes with several complications and risks listed below:
- Long recovery
- Blood clot
- Nerve damage
Is There a Better Treatment Option Over Spinal Surgery?
If we took a survey of patients who have lengthy chronic low back pain due to conditions such as arthritis, degenerative disc disease, disc injuries, spinal stenosis, or facet syndrome, most people would say no to having spinal surgery, including those who have had failed back surgeries.
Some people choose not to go the medical route and look for a holistic approach to manage pain. Patients may choose to place their care into the hands of an acupuncturist, massage therapist, physical therapist, or chiropractor. As we do recommend patients be co-treated by one or more of these healthcare practitioners, we are going to focus on chiropractic for this blog.
Chiropractic is a great option for debilitating low back conditions; At our office, we specialize in non-surgical spinal decompression. Spinal decompression is a non-invasive procedure when a patient lies on a mechanized, state of the art table that opens one specific disc level to help relieve spine pain and radicular symptoms. Spinal decompression angles the table to a certain degree depending on the affected disc level, so it only pulls one disc level of the spine. Spinal decompression currently holds an 85% success rate.
How Does Our Facility Operate the Decompression Program?
Just like with a traditional chiropractic patient, we will not perform decompression treatment until we sit down with the patient and discuss the issue at hand, take a set of x-rays and conduct a thorough neurological examination. We also like to review any MRI or diagnostic imaging to help confirm an appropriate diagnosis. In order to give patients the lives they want, we must first know exactly what is wrong so we know what type of examination we need to perform and the extensive treatment plan we need to design to meet established goals. Once the patient has agreed to care, we begin treatment immediately including spinal manipulation, decompression and 10 minutes of electric muscle stimulation during each visit.
Here is our biggest take home message from this week’s blog: If you or someone you know are tired of living in pain and have tried just about anything to do just that, please consider non-surgical spinal decompression over surgery. It could be your saving grace. If you have any questions about spinal decompression or concerns about spinal surgery, please feel free to call us at (724) 547-3377 and check out our website at www.drlarrywilkinsspinalcare.com for more content on spinal decompression. To learn more about our spinal decompression program, look back at our decompression blog.
Yours In Health,
Larry E. Wilkins, DC
Brian M. Steinert, DC