About Spine Surgery
Most initial episodes of acute back pain will resolve on their own, given time and rest. These are often treated with over-the-counter anti-inflammatories such as ibuprofen. Unfortunately, many patients will experience a recurrence of the back pain, usually within the first year. For those patients with continuing back pain, we recommend following a specific course of treatments ranging from more conservative to less.
When is spine surgery appropriate?
Common sense dictates that a patient would not cut their arm, then immediately go to a surgeon and ask them to amputate! Similarly, back patients should start with changes to their diet and exercise routine. Strengthening core muscles and losing weight may help resolve current and prevent future back pain. If that fails, patients should seek help from supervised physical therapy and/or chiropractic care. If these fail, traditional pain management techniques including medications, epidural steroid injections or other treatments may bring relief.
Only after all of these other methods fail should patients consider surgical intervention. The reason is simple: RISK. The risk factors associated with these treatment methods increase as the treatments become more invasive. Good, conservative medicine always includes a risk/benefit assessment and that leads good doctors to treat patients conservatively. Minimally invasive treatments for lumbar, thoracic and cervical spine issues have created an important, conservative step between traditional pain management and open-back spine surgery.
For many patients, undergoing a minimally invasive procedure will obviate the need for a more invasive spine surgery. However, if a minimally invasive surgery does not eliminate 100% of the pain, the procedure is repeatable and does not create future problems such as scar tissue, unlike more invasive procedures.
Finally, it is important to continue spine care post-operatively. Supervised physical therapy is strongly recommended. Because spine problems are degenerative and ongoing in nature, multiple issues are common as we age and patients want to do everything they can to prevent them. Core strengthening exercises can be extremely helpful, as can continued physical therapy and chiropractic care.