When Can Back Surgery Be Avoided?

Every year, a few hundred thousand low back operations happen in America. Overall the successful results from these operations depends on the reason for the operation along with the technical skill of it being performed.

How can a back operation be avoided and how is an individual to know if he or she is in the category of having the choice to successfully opt out of surgery and have it not be harmful in the future?

The primary thing to understand up front is what exactly is the diagnosis. Most common diagnoses for back pain include:

1. Degenerative Disc Disease

2. Herniated Lumbar Disc

3. Degenerative Spondylolisthesis

4. Wear and Tear Arthritis

5. Lumbar Compression Fracture

Once you understand what’s generating your pain, the diagnosis can then be placed into the categories of either 1) Quality of Life issue or 2) Indicated for Surgery.

First let’s look at Degenerative Disk Disease (DDD), which is a fairly common diagnosis between the ages of thirty and sixty. A significant amount of the population has DDD and no back pain. Others though may end up with significant back pain and disability.

DDD is not a diagnosis that necessitates surgery, it is a quality of life decision. In fact, surgery for DDD, which is typically a fusion, only results in 50-70% success rates and a significant amount of patients end up needing future surgery and continued pain medications. Non-operative treatment for DDD may help considerably including chiropractic treatment, aerobic exercise, NSAIDS, and pain management treatments.

Most low back issues are quality of life problems. If considerable nonsurgical treatments fail, then surgery may be undertaken electively. A low back herniated disk that is pinching a nerve is an elective decision if it is simply causing numbness or pain. if a person can handle the pain, then the literature shows that outcomes with surgery vs non-surgical treatment are the same after a year.

If however, one of the above diagnoses is causing a worsening neurologic deficit such as a foot drop, then surgery may in fact be indicated and not elective. The longer one waits when a neurologic deficit exists, there is a question of whether or not it will improve even with a surgery performed perfectly.

This is the same point with spinal arthritis. No one ever died from arthritic pain. So if arthritis causes a spondylolisthesis or some degeneration along with spinal stenosis and there’s no neurologic deficit from pinched nerves, the situation is elective. Electing for an operation is fine if nonsurgical treatment has been exhausted, there is a surgery for the specific condition with a successful track record, and the patient is healthy enough to undergo it. But if the condition is in fact elective, patients need to weigh the risks and benefits considerably to make sure they are okay with the potential for a sub-optimal outcome compared to the potential for marginal improvement with nonoperative methods.

These may entail spinal decompression, phoenix chiropractor, phoenix physical therapy, and Arizona pain management.

 

Last Resort Pain Management Treatment Of Degenerative Spondylolisthesis With Spinal Surgery

Degenerative Spondylolisthesis is a spine problem that ends up with one vertebra slipping forward on the one below. The resultant pain can be situated in the legs or back from spinal stenosis. The condition can be treated nonoperatively as it is not life threatening. When it comes to an operation it is a quality of life decision. Typically the slipping occurs of Lumbar 4 on top of Lumbar 5, but one may see it at multiple levels too.

If nonsurgical treatments fails, such as with phoenix physical therapy, surgery is offered as a last resort. The typical spine surgery for degenerative spondylolisthesis involves a decompressive surgery to free up any nerves that are being pinched. This is called a decompressive laminectomy. In addition to freeing up nerves, the surgery usually involves stabilizing the one vertebrae on the other. This is done with a spinal fusion and may involve screws and rods placed in the bones on one or both sides of the unstable level.

It’s unnecessary to reduce the slippage as freeing the nerve roots will decompress the pinching and typically it’s more problematic than it is worth. Also, bone graft materials is positioned on each side of the spine so that a fusion of one level to another will be facilitated.

Does the operation have satisfactory results? The answer is a definite yes. In the world of spine surgery, procedures for degenerative spondylolisthesis have overall very favorable outcomes. Individuals often spend 1 to 3 nights in the hospital, and the operation works well in resolving both back and leg pain.

Unlike many types of spine surgery that have questionable outcomes, spinal decompression and fusions for degenerative spondylolisthesis work typically very well. Once again, it is a last resort procedure quality of life decision. At the beginning, treatment should be initiated at an arizona pain center with treatments such as PT, arizona chiropractor, spinal decompression, and interventional pain injections such as facet blocks and.