If you need back surgery, consider yourself lucky.
Yes, lucky. Techniques used for back surgery have improved dramatically over the last 10 to 20 years, with better results for patients.
“Years ago, spine surgery was much more invasive. Big, soft muscle tissues were affected, and it was common to remove big chunks of bone cartilage of the spine to get to the problem area,” says Farzad Massoudi, M.D., F.A.C.S., Medical Director of the Neuroscience and Spine Institute at Mission Hospital. “There was a prolonged period of convalescence and post-operative pain.”
Spine surgery techniques today offer minimally invasive solutions to many back problems. “As our understanding of the problems that affect the spine has evolved, we’ve developed less invasive and more focused methods of surgery,” he says.
WHEN TO CONSIDER SURGERY
Of course, non-surgical treatment for many back problems should be the first approach, Dr. Massoudi says. Anti-inflammatory medications, rest and physical therapy can be effective for some common back problems. “Surgery is recommended after all non-surgery options that are plausible have been tried,” he says.
But for debilitating or very painful back problems, such as a herniated disk (the little cushion between bones pushes outward) or bone spurs that press against the spine, surgery can help relieve pain.
“Removing very small amounts of bone with more exact and precise techniques means that surgeries take less time, with less risk to patients and faster recovery,” says Dr. Massoudi, who treats a range of spine problems.
“In younger patients, particularly people in their 20s and 30s, we see sports-related injuries,” says Dr. Massoudi. “In patients over age 40, the most common problems are degenerative and age-related.” A genetic predisposition to developing back pain can cut across all age groups, he says, adding that there is a growing awareness among researchers that back problems that cluster in families may be genetically driven.
The wearing out of disk cartilage, though, is part of getting older. And when this happens, the spine loses structural integrity, which can lead to pain.
Spinal stenosis, or the narrowing of the space that holds the spine, typically happens in the lumbar (lower back) or and cervical (neck) areas, and is also associated with aging.
Should back surgery be a last resort? Not always, says Dr. Massoudi. “If a patient is developing weakness or numbness, or is having bowel and bladder problems, or radiating pain that affects daily activities, then surgery is the first resort,” he says.
FINDING THE RIGHT SURGEON
Some patients are wary of surgery, even when it could help reduce or eliminate pain.
“People should understand that in the hands of the right clinical surgeon and physician, with a proper diagnosis and proper treatment, there is a proven success for spine surgery,” says Dr. Massoudi. “For the right patient, surgery can be a life-altering experience.”
It is critical to find an experienced, trustworthy surgeon. It may seem daunting, but do your research, says Massoudi. The spine surgery market has attracted opportunists ready to take advantage of patients in pain by offering quick fixes that do little or no good.
Investigate doctors and talk to people who’ve had successful experiences with back surgery for a surgeon referral.
Promises of easy cures, such as laser treatments, should send up a red flag.
“Laser is a heat source and because of that we normally don’t use it near neurological structures and nerves due to potential for damage,” says Dr. Massoudi. “If you hear about a back center that is promoting laser solutions, be extra careful. We see a lot of patients who’ve been lured in by claims and have spent thousands of dollars out of pocket because of treatments that are not recognized or approved by insurance companies.”
Seek out known, reputable institutions. The Neuroscience and Spine Institute at Mission Hospital provides comprehensive services for people suffering from back problems as well as traumatic brain injuries or strokes.
And look for a doctor with a record of good care who is current on medical literature and provides proven treatments tailored to patients’ specific needs.
“In our comprehensive spine program we treat patients in a manner that is logical, cogent, and based on the latest understanding of what works,” says Dr. Massoudi.