Innova Pain Clinic
Risks of Spinal Surgery Detailed in Research Study
"In God we trust; All other must bring data." -Deming
As a population we intrinsically know that surgery has risks. We especially know that major spinal surgery is very risky. You don’t have to go far to find someone who had major spinal surgery and suffered a complication. But talking with individuals about their poor-surgery outcome is not a fair way to judge practice. In science, there is an expression coined and made popular by W.E. Deming: “In God we trust; all others must bring data.” It means that anecdotal evidence is great while sharing stories around a campfire, but it does not hold much weight beyond that. The data, or facts, support the plan of action.
I came across a research article in the Journal Spine. It details the rate of complications with major back surgery. The research team looked at 942 cases and analyzed the data. Here are some very interesting points from the research team:
- 87% had a least one documented complication
- 73.5% had a postoperative complication (8% delerium; 7% pneumonia; 5% naturopathic pain; 4.5% dysphagia; 3% neurological deterioration; 13.5% wound complication)
- 39% of those patients had to stay longer in the hospital as a result of their complication
- 14 people died after receiving back surgery
- 10.5% had an intraoperative surgical complication
I share these facts not to scare people away from surgery, rather to describe the options involved with spinal pain. There are always going to be cases where major surgery is absolutely the answer. But the majority of lower back pain does not require risky surgery. One needs to explore other treatment options completely before resigning to the surgeon’s scalpel.
Non-surgical Approaches:
Drug Therapy
Rarely a cure for mechanical back pain. I have written many articles on that topic. Pain meds mask the mechanical pain. They don’t fix it.
Massage
Tends to work well for mechanical lower back pain. The biggest two complaints I hear about massage therapy is the length of treatment sessions (at least an hour), and insurance does not pay for it. I completely understand the insurance issue. It seems unfair that a therapy which works is not covered by insurance so the patient has to pay the $70 out-of-pocket visit. If you need to see the massage therapist 4 or 5 times, that $70 can add up quickly. The one-hour time commitment can be a bit hard to manage with our busy work schedules. But I think massage therapy, rendered by the right professional, is worth it.
Chiropractic
Hands-down, my vote for the best choice. Chiropractors focus on the mechanical sources of the injury and address those specific causative factors. Most chiropractors in St George are really good at what they do. There are some crazy ones, just like in every profession, so make sure you choose the right St George chiropractor to fit your lifestyle and condition.
Acupuncture
Has also been shown to be safe and can be effective for certain types of lower back pain. I am not an expert on acupuncture. We do have some great acupuncturists in St George and I make referrals to them often. There is a great one just a couple blocks from my house. There is a very good one in the middle of town, right on Tabernacle.
Medical Pain Intervention
There are medical procedure options available as well. Patients can receive some benefit from low-invasive procedures such as Facet Injections, TENS, RF Ablations, percutaneal nucleotomes, and many others. We have some well trained pain specialists in town. There are three offices that I work closely with and we send referrals back and forth. If one of my patients needs to have some additional pain management, I call and coordinate the treatment.
When you have mechanical back pain, often your best option is to be examined by a chiropractor first. He can recognize your diagnosis and formulate an appropriate treatment plan. That plan might include other professionals as well.
Dr. Andrew White
Spinal Trauma and Back Pain Chiropractor
Reference:
Spine J. 2012 Jan;12(1):22-34. doi: 10.1016/j.spinee.2011.12.003. Epub 2011 Dec 29. Morbidity and mortality of major adult spinal surgery. A prospective cohort analysis of 942 consecutive patients.