{"id":7472,"date":"2016-02-25T23:20:31","date_gmt":"2016-02-26T04:20:31","guid":{"rendered":"https:\/\/brain-bodyhealth.com\/?p=7472"},"modified":"2019-03-06T13:49:05","modified_gmt":"2019-03-06T18:49:05","slug":"3-questions-you-must-ask-before-back-surgery-chiropractor-in-holland","status":"publish","type":"post","link":"https:\/\/brain-bodyhealth.com\/3-questions-you-must-ask-before-back-surgery-chiropractor-in-holland\/","title":{"rendered":"3 Questions You Must Ask Before Back Surgery – Chiropractor in Holland"},"content":{"rendered":"
Between 1998 and 2008, spinal fusion surgery (a form of back surgery) had increased 2.4-fold in the United States.(1)<\/sup> And the most common reason for the increase? Disc degeneration.(2)<\/sup>\u00a0Back surgery has its place and time, but opting for one is not a small decision. It\u2019s also a procedure that cannot be undone. Asking yourself the following questions will help you make an informed decision.<\/p>\n The short answer is NO<\/strong>. Although degeneration, bone spurs and disc herniations can look alarming on x-ray and MRI, they are not always relevant to one\u2019s pain and dysfunction. In fact, a 2015 review (3)<\/sup> says what you see on your films most likely has nothing to do with your pain. In other words, pain, along with degenerative changes, are not good enough reasons for back surgery. Read more about this topic here<\/a>.<\/p>\n Although there are spinal emergencies that need immediate surgical evaluations, sciatica caused by herniated disk or spinal stenosis ALMOST NEVER<\/strong> requires back surgery. (4)<\/sup> It is known that even patients with a massive disc herniation can do very well under conservative treatment. (5)<\/sup><\/p>\n If you have leg pain without neurological symptoms, then you should be treated conservatively. (6)<\/sup>\u00a0Having a negative straight leg raise test means surgery most likely won\u2019t work for you. (7)<\/sup> If you have sciatica, you are over 40, and you have severe leg pain, surgery probably won\u2019t work for you. (8)<\/sup>\u00a0When your MRI only shows a little compression on the nerve, you likely will do worse after surgery. (9)<\/sup> Most patients with chronic low back pain will NOT <\/strong>benefit from surgery. (10)<\/sup><\/p>\n Surgery may be appropriate when you have<\/p>\n So far, most of the studies available to answer this question are low quality studies. The consensus is that long-term results of back surgery are NOT<\/strong> superior to conservative treatment. (8,11,12)<\/sup> As of 2016, back surgery cannot be confidently recommended for lumbar spinal stenosis, because it doesn\u2019t provide better outcomes, and the side effects are much higher than conservative treatment (24% <\/strong>vs.<\/strong> 0%). (13)<\/sup><\/p>\n On average, one year after having a low back discectomy for disc herniation, a quarter of the patients have another herniation at the same level that received the surgery. (14)<\/sup> 22% patients have worsening low back pain in a year, and recurrent low back pain is as high as 36% among these people. (15)<\/sup><\/p>\n Fusion surgery is in your favor if you have a large compression onto the space surrounding the spinal cord, specifically greater than 1\/3 thecal sac compression. (9)<\/sup> However, 1 out 10 patients will be operated on again in a couple years, and 1 out of 5 will be operated on again in 10 years. (16)<\/sup> Basically, the studies are saying patients do pretty well after the fusion surgery\u2026the outcomes are good\u2026except that a good portion of them will have to come back and get the surgery again in the future. (17) <\/sup>So therefore, make sure it’s risk you are willing to take if surgery is what you opt for.<\/p>\n If you have back pain and you visit a surgeon, there is a good chance you will end up having back surgery, as demonstrated by a 2013 study.\u00a0(18)<\/sup>\u00a0(see graphic below). If you see a chiropractor first, there is a good chance you will avoid the back surgery that may not be necessary in the first place.<\/p>\n The bottom line is if you are experiencing back pain, find a good chiropractor who is familiar with the research, who knows what to look for, who knows how to check for the different indicators and neurological signs, and recommend care (surgical or not) based on existing evidence.<\/p>\n <\/p>\n <\/p>\n\n
Does degeneration and disc herniation automatically warrant a surgery?<\/strong><\/h5>\n<\/li>\n<\/ol>\n
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When to consider surgery for back and leg pain? <\/strong><\/h5>\n<\/li>\n<\/ol>\n
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Does back surgery have superior results compared to conservative care?<\/strong><\/h5>\n<\/li>\n<\/ol>\n
The Bottom Line<\/strong><\/h5>\n
References:<\/strong><\/h5>\n
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About the Author<\/em><\/strong><\/h5>\n