The Back Surgery Domino Effect

Back surgery has been shown to be necessary in only a small percentage of back pain cases.  There are clear indications for when surgery is necessary. Back surgery has been shown to only be indicated in less than 5% of all back pain cases.  That means 95% of back pain cases can be successfully managed with out surgery – even with disc herniation and nerve root syndromes.  That begs the questions -- why does the US have 10 times as many back surgeries than other industrialized countries?

Back surgery is also complicated.  Those that have back surgery have been shown to be at higher risk for a second back surgery.  I have seen MANY MANY people of the years that have had to have 2, or 3, or MORE back surgeries.  

Second back surgeries are even more complicated.  The Spine Patient Outcome Research Trail (SPORT) demonstrated a re-operation rate in patients with lumbar disc herniation were as high as 9% in 4 years and 13% within 8 years.  These were associated with complications from the first surgery. 

According to a recent research paper published in Spine (2015; 40(18)), patients going through second lumbar surgeries (revision surgery) showed an increased procedure time (longer anesthesia exposure), increased length of hospitalization (higher cost and hospital risk), and higher post-surgical narcotic utilization (greater pain, and greater narcotic risk exposure).  They also had higher post-operative pain scores and re-herniation rates and subsequent re-operation (increased risk of yet another surgery).  In fact, patients undergoing revision surgery were shown to be more likely to undergo subsequent lumbar fusion.  That's really bad news, because we have known for years that fusions increase the risk of damage at adjacent disc levels, and is directly associated with greater disability. 

Clearly, lumbar surgery increases risk of the dominos effect into more and more surgery. 

If you are having a back pain problem, it is wise to exhaust reasonable non-surgical options before considering surgery. If surgery has been recommended, it is wise to get a second opinion.  If you have had surgery, it is wise to do everything you can to increase the health of your spine and help reduce your risk of follow-up surgeries. 

If you have a back or neck problem, give us a call and see how we can help.  If you have had one or more spine surgeries, you should call us, too!  We help patients improved the health and fitness of their backs and necks in an effort to move away from more and more spine surgeries.  We have been helping people in Tacoma, Fircrest, and University Place for over 25 years. 

Author
Austin McMillin Chiropractor

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