Back Surgery Failures and Success Rate.
“My doctors said the surgery was a success, but I still have pain”
So many surgeries, so little success. As a chiropractor, I hear so many patients tell me that they have had some sort of spinal surgery in the past – Yet here they are in my office! Why? They have back or neck or shoulder or hip pain.
Sure some of these patients have had operations for emergency purposes, but may had them done because they were in pain to begin with. When asked, they tell me that their surgery was successful.
Spinal surgeons often quote a 98% success rate for fusion surgery. This percentage refers to the fusion process, not the reduction of pain. For single level fusions, the percentage of patients obtaining significant relief is approximately 40%. With three levels this drops to 15%.
Neurosurgeons give microdiscectomy a 95-98% success rate; however when success is defined as returning to their previous occupations without pain medications, the overall success rate plummets to 29%. Among spinal surgery patients, one out of every four patients is dissatisfied with their surgery two years post-op. (Surg Neuol 1998 Mar; 49(3): 263-7).
Potential Risks and Complications for Back Surgery
Potential risks and complications include:
- Blood loss
- Nerve injury
- Possible re-operation
- Lack of a solid fusion
- Continued pain or increased pain.
Medical complications include pneumonia, heart attack, stroke, or blood clots. (Form http://www.spine-health.com)
Other complication include the common issues associated with chemical pain management program. Demerol and Oxy-Contin are commonly prescribed medications for back surgery recipients, both are narcotics.
Conservative Care vs. Surgery
Many reports have been written about back pain. Most agree that conservative intervention is the first step, not surgery. It is not only safer than surgery, but also cheaper according to Daffner, Hymanson and Wang at 2% of the financial costs in 90 days of treatment. (Cost and use of conservative management of lumbar disc herniation before surgical discectomy. Spine J. 2010 Mar 31. [Epub ahead of print])
Another study published in Spine assessing long-term outcomes of conservative chiropractic care vs. surgical intervention for lumbar spinal stenosis states that groups were happy with their results, though the surgical group reported less severe symptoms of back and leg pain and “greater improvement in back-specific functional status after 8 to 10 years than nonsurgically treated patients. By 10 years, 23% of surgical patients had undergone at least one additional lumbar spine operation, and 39% of nonsurgical patients had at least one lumbar spine operation. Patients undergoing subsequent surgical procedures had worse outcomes than those continuing with their initial treatment. Outcomes according to actual treatment received at 10 years did not differ because individuals undergoing additional surgical procedures had worse outcomes than those continuing with their initial treatment.” (Spine (Phila Pa 1976). 2005 Apr 15;30(8):936-43.) The paper later says, “…surgically treated patients with a herniated lumbar disc had more complete relief of leg pain and improved function and satisfaction compared with nonsurgically treated patients over 10 years. Nevertheless, improvement in the patient’s predominant symptom and work and disability outcomes were similar regardless of treatment received.”
Basically that says these patients were able to heal over time and had the same level of improvement without drugs or repeated surgeries.
The choice is yours
As it should always be with regards to your health. Surgery or adjustments are the choice before patients suffering from back pain, herniated disks and sciatica. Many people chose the surgery for immediate relief, though days missed from work can be upwards of 2 months. The patients we see with similar complaints are usually well enough to be back to work in a week or two. We do this for them without drugs or surgery, and use chiropractic adjustments to their spine and physiotherapy techniques like massage therapy.