Conservative Treatment of the Spine Offers Better Results than Surgery. Learn Your Options Before You Opt for an Invasive Procedure.
Spine surgery is not as successful as many have been told. In fact, published research on the database of the Ohio Bureau of Workers’ Compensation reports the success rate at 26%. In this article, we will go over the various forms of spine surgery, including the minimally invasive spine surgery and spine fusion. We will also provide information on complications and long-term success rates. But before we start on the topic of spine surgery, we find it necessary to define success in clinical terms from doctors’ and patients’ points of view.
The Merriam-Webster Dictionary defines success as a “degree or measure of succeeding.“ In other words, any improvements or gains are considered successes achieved. A spine surgeon may view the surgical intervention as successful when patient symptoms decrease or when the quality of life increases. We have seen our fair share of symptomatic post-surgical patients who were classified as successful surgical cases.
Different Types Of Back Operations Procedures
In general terms, spine surgery is performed when the spinal nerve, spinal cord or thecal sac (housing of the spinal cord) are compressed to the degree that causes significant symptoms. Three main disorders lead to such compression are:
- Spinal disc degeneration, bulge, herniation, protrusion, prolapse, extrusion or fragmentation (slipped disc or slip-disc)
- Degenerative and arthritic changes in the facets (spinal joints)
- Hypertrophy thickening and degeneration) of the ligamentum flavum or other soft tissues impacting the spinal canal or spinal joints.
The primary goal of spine surgery is to decompress the compressive effects of damaged tissue, either by cutting them or through instrumentation (plates, rods, and screws). In some cases, both cutting and instrumentation are used. Decompression spine surgery involves the removal of structures or tissues that are compressing and putting pressure on nerves. There are several methods, and we shall discuss them briefly below.
Spinal Decompression: Laminectomy/Laminotomy, Facetectomy, Foraminotomy, and Partial Discectomy
Spinal decompression surgeries are sometimes touted as the minimally invasive spine surgery. They are called minimally invasive spine surgery, as most can be performed using the keyhole method. However, just because they are considered minimally invasive doesn’t make them any more successful or non-intrusive. In fact, any time you cut into tissue, it is invasive and even damaging to muscles, ligaments, spinal discs, spinal joints, or spinal nerves. As such, they fail to provide long-term relief.
Radiofrequency (RF) Ablation or Radiofrequency Neurotomy for the Chronic or Acute Spine Pain
The Radiofrequency ablation or Radiofrequency Neurotomy is minimally invasive spine surgery. The primary goal of radiofrequency ablation or neurotomy is to destroy the nerves that sense pain. The term Neurotomy is descriptive of surgical interventions that cut or destroy nerves that sense pain. Ablation is a general term meaning taking away or removal. In surgical scenarios, ablation applies to the surgical removal of tissue. In short, Radiofrequency ablation and radiofrequency neurotomy are interchangeable terms used is the destruction of the innate or inherent functions of nerves. It is carried out through radiofrequency that generates heat by radio waves. RF ablation has the most conflicting research when it comes to clinical successes. Some call it an absolute failure while others cite mild relief of pain, temporarily.
Radiofrequency ablation or radiofrequency Neurotomy may provide you pain relief for 6-18-months at best according to experts who studied this procedure!
So, why would you take the risk with methods known to fail in the long-term? Do you cut the wire to the light that illuminates the check engine? You wouldn’t because the problem will still be there and in time you will have more significant issues! The same applies to your body. Why would you cut or kill the nerve that warns you of a problem? Take our advice; short-term gains through invasive methods are wasteful at best.
Our clinical teams are opposed to any invasive procedures when it comes to the spine, including the minimally invasive spine surgery. RF or Neurotomy regardless of its level of invasiveness is a procedure best avoided. The harm inflicted on the joints and soft-tissues outweigh even the best-hopped scenarios. In short, there are no shortcuts to getting better. Cutting away the nerves or killing them with heat or radio waves do not constitute a cure. Seek useful conservative treatment options before opting for this invasive procedure. Visit a Chiropractic Specialty Center® today and learn about the best comprehensive means of spine care.
Spinal Decompression Through Laminectomy/Laminotomy
The lamina are the bony structures at the rear of the spine. They protect the spinal canal and enable the attachment of critical ligaments for spinal stability. Your spinal canal starts at the base of the skull and runs all the way down to the tailbone. Laminectomy is a minimally invasive spine surgery that removes the lamina. Earlier we mentioned that the lamina has the attachment point for a critical ligament. Ligamentum flavum is a highly specialized ligament that connects spinal segments with one another through their laminal attachment points.
Decompression of Spine Performed Through a Foraminotomy
Spinal nerves originate from the spinal cord. As they leave the cord, they pass through a passageway. The passageway provides protection and an exit point for the spinal nerves. These passageways are termed intervertebral foramina or foramen. But, the foramina are not a passage just for the nerves. Other structures also pass through this opening, including the spinal artery, veins, and Sinu-Vertebral Nerve (the major pain-sensing nerve for spinal discs, spinal joints, and joint ligaments). The borders of the spinal foramina are formed by the spinal discs, spinal bones (vertebral bodies) anteriorly, and spinal joints (facets) posteriorly. Arthritic or degenerative changes of spinal discs, vertebral bodies, and facet joints will result in narrowing of the foramina.
Narrowed spinal foramina (vertebral foramina) are classified as stenotic. The term used to describe such conditions is called foraminal stenosis. The narrowed foramina (foraminal stenosis) compress the spinal nerves and vessels within the passageway (vertebral foramen). Foraminotomy is the process of removing portions of the bony walls (pedicels of the top of facets or parts of vertebral bones), spinal discs, or both. Furthermore, the cutting or spinal discs and pedicles on top of facets may lead to instabilities. As a result, the majority of patients who undergo a foraminotomy need additional surgical interventions such as a nucleoplasty, laminectomy, discectomy, or spinal fusion in the future.
Nucleoplasty: A Useless Invasive Spine Procedure With Far-Reaching Consequences!
A published research study in the Journal of Spine Disorders and Techniques reported nucleoplasty with or without intradiscal electrothermal therapy (IDET) as ineffective. The published study reported the impacts of nucleoplasty on nine patients. A total of 32 discs in these nine patients was treated with neuroplasty. The authors reported the average patient pain level before nucleoplasty at 6.7 (on a Visual Analog Scale or VAS of 1-10, with 10-being excruciatingly severe). Nine months after nucleoplasty, pain levels were documented at a 5.6, equating to about a 10% decrease in pain. In other words, nucleoplasty has a failure rate of 100% because none of the nine patients were rendered pain-free. They only improved by 10% on average! As such, the authors concluded nucleoplasty with or without IDET as ineffective.
Discectomy is the type of Operation that removes the Spinal Disc in part or totally.
The spinal discs are the separators, connectors, shock absorbers, and stabilizers of the spine that provide mobility and weight bearing. Poor posture, prolonged sitting, and repetitive traumatic events lead to degenerative changes that impact the health of spinal discs. A degenerated spinal disc is a weak structure that is unable to provide efficient loadbearing and mobility. In time, a degenerated disc can succumb to stresses of daily life causing the spinal disc to tear, bulge, herniate, or rupture. A bulging disc or a herniated disc is better known by its layperson term, slipped disc or slip-disc.
Spinal Fusion: An intervention for severe cases or for failed laminectomy (laminotomy), facetectomy, foraminotomy, nucleoplasty, and partial discectomy.
Spinal fusion is a surgical intervention that has been around for decades. It was the go-to method of spine surgery for most surgeons. In spinal fusion, the surgeon attempts to fuse spinal bones together either through implants, a bone graft, or a combination of the two. The goal of fusion is to stop mobility or motion in segments that are hypermobile, unstable, or excessively damaged. There are various methods of spinal fusion, including a minimally invasive spine surgery.
How Long Does It Take to Recuperate from the Operation?
Recovery from spine surgery can take 3 to 4 months. In fact, 3 to 4 months is the minimum. For some patients, it can take six months or more. The rate of recovery depends on your overall health, the skill of your surgeon, follow-up care, home care, and your activities of daily living. In short, you will need to give it some time. However, if your symptoms come back after surgery, you are not alone. It is common, occurring in more than 80% of cases. Complete recovery to a point where you are free of all symptoms is rare to non-existent. Unless, of course, the surgical intervention was performed on relatively minor conditions that would have done well with conservative treatments.
Always seek a second and third opinion before considering surgery. For best results, consult a second surgeon and a nonsurgical spine specialist before you opt for spine surgery. We will be happy to provide this service for you.
How successful is the back operation? Let’s see what research on the Spine Journal reported.
According to a published research article in the renowned Spine Journal, fusion causes spinal stenosis, disc herniations, and instabilities next or adjacent to the surgically fused segment. In other words, patients who were operated through spine fusion surgery developed spinal disc problems in segments that were healthy before surgery. Spine surgery (laminectomy, foraminotomy, discectomy, nucleoplasty or spinal fusion) can reduce pain if successful but it will also hamper your spine’s ability to function normally. In time, the operated-on segment or those near the surgical site will decay or degenerate faster. Spinal fusions have the highest rate of degenerative changes in the good ones. We have provided the recap of that research below:
Let’s Look At Facts Explaining Why Spine Operations Fails?
A failed spine surgery is one where patients experience reemergence of their back pain or symptoms after spine surgery. The recurrence of symptoms is the result of multiple factors. Symptoms or pain reemerge because of accelerated degenerative changes brought forth by the biomechanical factors from the spinal column post-surgical intervention. Back surgery always leads to biomechanical changes. These changes will impact load-bearing activities at surgical segments as well as sections adjacent to the surgical vertebra. These biomechanical changes are present with even the most minor of procedures. In other words, it is present in the minimally invasive procedures as well as in major spine procedures such as the spinal fusion. However, the instabilities associated with spinal fusions are significantly higher when compared to a laminectomy, foraminotomy, facetectomy, or partial discectomy (forms of minimally invasive spine surgery).
An article in the European Spine Journal reported the failure rate of eliminating patient pain or symptoms through invasive spinal decompression methods by experienced surgeons at 90% two months after the operation. The failure rate drops to 75% after five years with painkillers (medication).
The European Spine Journal published research on the five-year outcome of lumbar surgical decompression performed on 149 patients by four experienced spine surgeons. This study concentrated on spinal decompression surgeries performed through laminectomy, foraminotomy, facetectomy, or partial discectomy. The authors reported that 90% of patients still complained of a varying degree of leg pain two months after surgery.