Spinal Surgery:

Recent studies indicate that back surgery is third only to tubal ligations and caesarean section. With back pain affecting up to 80% of the population in the United States, at some time in their lives, this high rate of surgery is not surprising.  Except that many people feel spinal surgery is used too excessively when indications for surgery are either not clear or nonexistent. With arguments against spinal surgery ranging from "few surgeries are proven effective" to a lack of consensus as to when surgery is appropriate, the ongoing debate has drawn much attention from the American consumer.

But this is not to say that spinal surgery has no purpose. Few would argue against the need for surgery following a spinal fracture or for the removal of tumors and/or cancer.  There are instances, such as the medical consensus for back surgery for "instability," of which there are no clear clinical consensus on the definition of instability existing today.  At least one study has shown that disc herniation, thought often given as a reason for surgery, is common and asymptomatic (without symptoms) in some people, causing experts to question whether the disc herniation is in fact the cause of the pain.  Adding further to this question, is the fact that many surgeries to correct disc herniation do not result in the resolution of the pain.  Herein lies the problem ultimately a problem for the patient. So how does the patient with back pain know when surgery is recommended, is it the most effective method of treatment, and what are viable options to try before agreeing to surgery?

Spinal manipulation or adjustments, perhaps is one of the best studied treatments for low back pain.  The U.S. Department of Health and Human Services released a clinical practice guide for the treatment of acute low back problems in adults that recommend spinal manipulation as the first line of treatment for low back pain. There is evidence existing that spinal manipulation, as performed by chiropractors, is effective in the treatment of low back pain for two to three years. Other studies have demonstrated spinal manipulation to be effective for treatment of low back pain in both chronic and acute cases.  Never allow an untrained person to manipulate you.  Only Doctors of Chiropractic and Doctors of Osteopathy are extensively and formally trained in manipulation in their professional colleges. A study by the Rand Corp. found that 94% of all manipulations or adjustments performed in United States are performed by chiropractors. 

Some people may find pain relief through the use of non-steroidal anti-inflammatory drugs (NSAIDS).  The problem with using NSAIDS is that the pain is simply covered up, without the benefit of knowing what caused the pain. All drugs are associated with side effects and should be used with caution.  If you have chronic back pain, long-term drug use may lead to other serious problems.  In fact, the U.S. Food and Drug Administration estimates that 10,000 to 20,000 people die each year from stomach problems caused by NSAIDS use.

If you are faced the prospect of spinal surgery, ask your physician the following questions:

1. What is the evidence that shows that I would benefit from undergoing the surgery you are recommending?

2. Is the evidence based on randomized clinical trials?

3. If the surgical procedure is new, how many people has it been used on and what are the success rates and complications? If it is an older procedure what is the evidence that shows that this procedure is necessary and effective?

4. What are the known risk versus the benefits?

5. Will rehabilitation follow surgery and what plans have been made to carry it out?

6. How many times has the surgeon performed the procedure and what are his or her success rate?

Chiropractic should always be your first line of treatment of the spine. If you're facing the prospect of spinal surgery and not satisfied with the answers to the above questions, contact Dr. Skaggs at 417-624-4242.  Remember Chiropractic first, Drugs second, and Surgery is always the last resort.

Disclaimer:  No individuals, including those currently under our active care, should use the information and/or resources contained here within to self diagnose or self treat any health related condition(s).  Diagnosis and treatment of all health conditions should only be performed by your doctor of chiropractic or other licensed health care professional.