Every expert will tell you, you want to try every possible
non-surgical option before resorting to back surgery. Surgery can be high
risk and seldom allows you to truly recover your quality of life. In
fact, in many cases, those who have surgery end up with even more
problems.
Back surgery patients compared to non-surgical spinal decompression patients require a longer recovery time, require a significantly longer disability restriction from work, and frequently depend on heavy duty narcotic / opioid medications to manage their post surgical chronic pain.
As a result, many back pain sufferers opt for prescription
medications to mask the pain, or injections that will temporarily
relieve the pain.
Short term fixes; band aids on a problem that, if not
addressed, will only get worse over time.
With spinal decompression therapy we work to get to the source of the
pain and treat the cause. By gently opening the spine and taking
pressure off the disc, we can often eliminate the pressure on the nerves
that is causing radiating pain down your arms or legs.
At the same time, we are allowing oxygen and nutrients in to
re-nourish the disc and restore it to health. Some preliminary research
indicates that spinal decompression therapy can actually increase disc
height.
With
non-surgical spinal decompression, there is no cutting, no anesthesia,
and no process to create an infection. No hardware is screwed to the
bone and nothing is cut away. It is generally very safe, very gentle,
very relaxing, very effective. It expands the disc height which usually
improves the range of motion, which can decrease the stress on the
neighboring levels.
Spinal surgery is tremendously expensive, generally results in decreased flexibility, places the body under a lot of stress, has a high degree of severe risks, and should be a last resort.
Many patients of ours have been told at the emergency room, or the surgeons office that:
1. Surgery is your only option (generally false) 2. Without surgery you will only get worse (many post-surgical patients are worse post surgery, and statistically most non-surgical spinal decompression patients have measurable significant improvements.)
The truth regarding spinal surgery Vs. conservative care is:
1. Conservative care should be tried for at least 4 to 6 weeks before any advanced imaging (MRI, CT, etc.) or testing, especially in acute radiculopathy Am Fam Physician. 2009 May 1;34(10):1066-77. 2. Conservative care is reasonable, especially the aggressive, non-surgical type of care for stenosis. Spine (Phila Pa 1976). 2000 Jan 15;25(2):197-203; discussions 203-4. 3. Conservative care compared with surgical care for spinal stenosis offered nearly equal relief (50% non-surgical vs 53% surgical) in reported improvement at 8-10 years after care. Spine (Phila Pa 1976). 2005 Apr 15;30(8):936-43. 4. Conservative care compared with surgical care for lumbar disc herniation offered similar relief in reported improvement (69% of surgically treated vs 61% of non-surgically treated). Spine (Phila Pa 1976). 2005 Apr 15;30(8):927-35. 5. Conservative care of radicular pain (arm or leg pain) may be superior to surgery based on cost, morbidity (death), and complications. 6. Conservative care compared with surgery for spinal stenosis and disc herniation and leg pain: surgery gives short-term relief of symptoms that decline over the long-term. Spine (Phila Pa 1976). 2009 May 1;34(10):1066-77.
Severe back pain is frightening, can result in disability, is frustrating, and can make a patient so desperate for a solution they may easily be frightened into making a decision in thinking surgery is their only option. Almost all of our patients that require Spinal Decompression Therapy, classify this as their last option before surgery. Fortunately, our success rate is super high and rarely does a patient that completes our protocol still require surgery. During our thorough examination we can usually predict whether your outcomes will be good, or that the therapy would not be a logical solution.Spine (Phila Pa 1976).Spine (Phila Pa 1976).Spine (Phila Pa 1976).Spine (Phila Pa 1976).
"Although surgery may be suggested, there is no guarantee that it will help with the pain."
Dr. Timothy Kremcheck M.D. is regarded as one of the top orthopedic surgeons in sports medicine. Dr. Kremcheck is the medical director and chief orthopedic physician for a Cincinnati professional baseball franchise and other sports franchises including professional soccer and minor league baseball. Dr. Kremcheck knows firsthand the risks back surgery presents. "I've had back surgery, I've had back surgery when I was a young resident in orthopedic surgery and my back has been a problem ever since because of the surgery and it's something that I wish I could have turned back and I wish I would have had non-surgical spinal decompression back then. It would have worked and so now I am paying for it for the rest of my life."
Now a staunch advocate for spinal decompression therapy, Dr. Kremcheck suggests exhausting every opportunity possible before opting for back surgery.
"With back surgery the risks are enormous. Things that go on and potentially go wrong with back surgery are enormous and they are life long, so anything that you can do non-operatively has got to be your first choice second choice and again multiple choices after that." Spinal decompression takes the disc from protruding and puts it back to the normal position and takes the pressure off of the spinal cord and the nerve roots and therefore takes a lot of the pressure and the spasm off of the musculature in the lower back, increases the range of motion, decreases the pain enhances the function of movement to do whatever you want to do." "If I have a patient that comes in, and they've got back pain or neck pain, before I would recommend that they have a surgery procedure or invasive procedure - even an epidural injection I would recommend the disc decompression because there is no downside to trying this and it works."
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"Minimally invasive" spinal surgery is a term used as a marketing advantage over "open back surgery or laminectomy".
Minimally invasive back surgery has a smaller incision (usually less than 2 inches), and less cutting through the muscle as compared to open back surgery. To gain access to the spinal column mechanical spreaders are used to stretch the spinal muscles out of the way (muscles that are prone to be VERY tight in back injuries). The damaged disc between the spinal vertebrae is obliterated with either a laser, or with a high speed Dremel tool like instrument. The diminished disc space is expanded and a piece of cadaver bone or a portion of bone from the patients pelvis is harvested and is inserted in the space where the disc was prior. To stabilize the tissue a metal bracket is mounted on the front portion of the vertebral bodies or through the pedicles with titanium screws to stabilize the level above and below while the body fuses the two levels over a period of two months. This procedure is medically termed anterior decompression and fusion.
Occasionally another type of back surgery involves inserting a probe between the spinal levels which can slice off the protruding disc material off of the nerve. This maneuver is risky on two counts because that disc material usually is pressing directly on a nerve root and any contact with the nerve with the surgical instrumentation can cause instant significant irreversible damage to the nerve root. The disc remains "deflated" due to the loss of nucleus pulposus material which can lead to immediate or eventual Stenosis of the lateral vertebral foramen.
An excellent youtube video detailing a patient's "positive" experience in surgical cervical spinal decompression can be found at: http://www.youtube.com/watch?feature=player_detailpage&v=m0A_nORRQ28
Lumbar Spine Surgical Disc Decompression
**Note the Large pedicle screws which are Titanium Screws penetrating the pedicle through the vertebral bodies.
Surgical Spinal Decompression is expensive, more
difficult to rehabilitate, creates scar tissue and bruising (both
visible on the skin, and underlying soft tissue {muscle, tendons,
ligaments}) and has an unfortunate frequency of failures requiring
additional surgeries.
Unfortunately, for the patient who has a fusion:
About 25% of all grafts do not take and it is necessary for another fusion to be performed. Less than 50% of conventional surgeries, including fusions, alleviate the pain and symptoms. Recuperation is long and painful. Fusions may cause other spine conditions down the road
Why the high frequency of additional surgical interventions? The
number one reason is due to the site of the surgical disc level having a
significant reduction in natural range of motion, the disc segment
above attempts to accommodate for the loss in natural motion. This
accommodation results in unnatural stresses to that neighboring level(s)
which frequently damages that level in the future.
Other reasons for
additional surgical intervention is a buildup in scar tissue from the
soft tissue damage which may need to be reduced (of course surgically), and infections from the
surgery which may need to be surgically drained, or occasionally these
infections attack the bone. With each surgery there are potential risks
including nerve damage (paralysis), infection, bleeding,
bowel/bladder/sexual dysfunctions. Medical complications include heart
attack, pneumonia, blood clots, and death. Spinal surgeries have been
documented to have a less than 50% success rating in regards to significant relief of symptoms, long-term disabilities or other consequences.
Cervical Spine Surgical Disc Decompression
** Note the Large titanium screws fixing the titanium plate to the front of the vertebral body.
Study: Riskier surgeries for back pain raise costs
