12.06.12

New & Improved Back Surgery?

Posted in Back Facts (spine), Disc Data, Guidelines for Treatment at 1:03 PM by Dr. Greathouse

Back Surgery
A recent Chochrane review of medical data bases & libraries to date finds that the latest & greatest modern medicine has to offer in the quest to successfully treat back pain, total disc replacement (TDR), falls short. The review reports that TDR has limited clinical advantage over fusion. In other words, there’s no clinically relevant improvement in outcomes.

This is bad news because the outcomes of spinal fusion are less than stellar in the first place, in fact, they’re poor.

We’ve seen the evolution of back surgery, including fusion, an attempt to stop movement in the offending joints, change 180 degrees, to the disc replacement, trying to preserve movement. Both have demonstrated limited utility in addressing back pain. There are exceptions to the rule but studies and reviews prove that the lion’s share of these procedures are ineffectual and can have significant complications.

Let’s not forget microdiscectomy, chymopapain injections, percutaneous discectomy, percutaneous laser discectomy, and percutaneous arthroscopic (endoscopic) discectomy. These procedures are touted as less invasive, which is a good thing because the other procedures leave behind a wound site that looks like a bad accident, with plenty of scar tissue to follow. Not good! The less invasive procedures did reduce iatrogenic complications, but were only successful for a “select few”! Determining who is a  good candidate for the procedure was and is the problem today.

So what’s my point? The rule in healthcare as it relates to spinal surgery for back or neck pain is; exhaust all conservative forms of care first. Statistically, once this is done your surgical success outcome increases a great deal!

Also note that the outcomes for all or no procedures are about the same in about nine months to a year. So, don’t rush to surgery, there’s usually no turning back after that fails and subsequent surgery outcome stats get worse and worse.

I practice two mechanical treatment protocols for disc problems, with a good success rate I might add, and with little to no complications. Go to GreathouseChiropractic.com for more information on conservative disc treatment protocols with good success rates.

Be Kind To Your Spine

Cochrane Reviews are systematic reviews of primary research in human health care, and health policy. Internationally recognized as the highest standard in evidence-based health care.

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