Is back surgery for back pain necessary? Sometimes. It is reasonable to consider spine surgery if the pain has not diminished after months of non-surgical treatment, if pain does not respond to medication, or if you’re unable to complete basic daily activities. Some surgery options are minimally invasive (microdiscectomy for a herniated disc) and allow for quick recovery, while other types of surgery (a posterolateral fusion for degenerative disc disease) are more extensive.
Advancements in spine surgery
Modern spine surgery has made major advancements in both technique and spinal instrumentation/implants over the past couple of decades, but by far the most significant advancement in spine surgery has been better preoperative imaging techniques, which have greatly improved the ability of surgeons to identify accurately and correctly an anatomic lesion as a cause of pain.
Specifically, magnetic resonance imaging (MRI scan) has revolutionized back surgery. It is most often the best test to identify an anatomical lesion responsible for the patient’s problem.
The most important factor in the determination of the success in spine surgery is proper preoperative diagnosis. Without an accurate preoperative diagnosis, even the most technically successful surgery has little chance for a successful outcome.
Spine surgery can basically accomplish three tasks:
- Decompress a nerve root or the spinal cord
- Stabilize an unstable or painful segment with spinal fusion surgery
- Reduce a deformity (e.g. scoliosis surgery in the thoracic spine).
Spine surgery is not done for exploration. The cause of a patient’s pain is not readily apparent with opening and exploring the spine. The preoperative evaluation and imaging results are what identify the problem and guide the design of the procedure.
Psychological preparation for Back Surgery
- Less distress and anxiety both before and after surgery
- Fewer complications related to the surgery and recovery
- Less pain and less need for post-operative pain medication
- Less anesthesia requirements
- Quicker return to health
- Shorter hospitalization period
- Reduced healthcare demands due to empowering the patient to take more responsibility for her/his recovery
- Increased patient satisfaction with treatment
- Reduced cost per surgery