A great friend of mine is looking for back surgery information. As we know this is one area where not much is know about what works. Any ideas? If so please comment:

I’ve been dealing with a couple of herniated disks in my lower back for the past
2 years.  Over that period of time, I’ve tried treating the pain with epidural
steroid injections, physical therapy, manual manipulation and deep tissue
massaging, acupuncture, and lots of fun pain "cocktails".  These treatments have
provided, at best, temporary relief from the pain.  And lots of crazy
hallucinogenic dreams! 

Last week I had a discogram (a diagnostic procedure to determine how badly
damaged the disks were), to enable my doctor to determine what type of surgery
would be best.  Talk about hallucinations… that Demerol is good stuff!  We
went through the results last night and, unfortunately, it’s worse than we
thought it would be.  One of my disks is so badly torn across the posterior of
the disk that procedures like a diskectomy or laminectomy won’t work.  I have
the option of either full disk replacement (which is a pretty involved abdominal
procedure where they replace the disk with a stainless steel mechanism that
works on a ball & pivot system… call me the "bionic woman") or a procedure
called an Intradiskal Electrothermal Therapy (IDET) that essentially cauterizes
the outside of the disk to kill some nerve root endings and seal off the tears
in the disk.  It sounds pretty high tech and cool… if it weren’t going to be
performed on me! 

My understanding is IDET is a short-term solution and, eventually, I’ll
need to have my disc replaced.  But I’ve also learned that there are a lot of
new disc replacement technologies in the works so it’s in my best interest to
hold off on the more involved procedure.  That said, I’m leaning toward the IDET
option since it seems the least risky course of action and could potentially
reduce my pain immediately with no major side effects.  Unless you count the
humiliation and trauma from having to wear a stiff plastic corset for 10-12
weeks after the procedure? If you know someone who has had disc replacement surgery or an IDET
procedure and is willing to talk with me about their experience, I’d really
appreciate it!  Also, if you have any recommendations of really good surgeons
for my second opinion, I’m looking for referrals, too. 

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24 Responses for “QUALITY: Back surgery request”

  1. Before pursuing back surgery, take a look a this recent online article:
    http://abcnews.go.com/Health/PainManagement/story?id=3282712&page=1
    Dr. Hadler is a medical curmedgeon and his epidemiology is bullet-proof. He suggests that most back surgeries for low back pan are not worth the risk. He believes that this hyper-marketed intervention produces marginal outcomes, or worse.
    I like the physical medicine docs. If a bad back can be fixed without surgery, they can do it. Find a physiatrist near you via the following link:
    http://www.e-aapmr.org/imis/imisonline/findphys/find.cfm
    Best wishes!
    Benjamin Atkinson
    http://www.ih-center.com

  2. bev M.D. says:

    As a pathologist married to an orthopedist, I would also urge caution before pursuing back surgery. My husband’s longstanding opinion is that chronic back pain is the most frustrating and least understood problem in orthopedics.
    You don’t say your age and weight, but keeping/attaining an optimal weight and ensuring your core muscles are strong are cheap beginnings. I would also recommend you get a second opinion, perhaps from an academic medical center in your area, wherever that is. This will hopefully confirm that you have the correct diagnosis and offer an expert opinion on these new and unproven techniques.
    Unfortunately the incidence of back surgery has been one of those that has been rising exponentially with limited data that it is significantly better than nonsurgical treatment (except for special situations
    that do not include disc herniation).
    Once you have back surgery of any kind, the anatomy is permanently changed, and it can confuse further evaluation and treatment if the initial surgery doesn’t work. I like the physiatrist idea, too.
    If you can get hold of this recent editorial in the New England Journal of Medicine concerning back surgery, here is the reference:
    Deyo, Richard, M.D., M.P.H.; “Back surgery – who needs it?” NEJM 356:2239-2243, 2007.
    Good luck. As one with chronic episodic back pain for 25 yrs, I sympathize! (ps once I started consciously using my quads instead of bending from the waist, my back has felt much better this gardening season.)

  3. bev M.D. says:

    Just an addendum;
    I have since run across another cited NEJM article that reminded me of an important distinction. (Deyo RA, et al, “Spinal fusion surgery: the case for restraint” NEJM 350:722-6, 2004) If you have leg as well as back pain (e.g. sciatica), that is a different situation than just back pain. The following quote from the editorial mentioned in my previous comment cites this reference to say (parentheses mine):
    “Another unresolved question concerns the use of spinal fusion or disk replacement for patients with only back pain (e.g. not leg pain) and degenerated disks. European trials have reached conflicting conclusions, though the discrepancies may be explained by differences in nonsurgical treatments; structured rehabilitation incorporating cognitive-behavioral therapy seems to be nearly equivalent to surgery for such patients.”
    Of course, this is a comment by a nonexpert on a blog, check it out with whatever docs you wind up seeing.

  4. One reliable resource for information seems to be http://www.spine-health.com/ – it is full of info, although I haven’t browsed it all.
    Best luck, Matthew!

  5. Kate says:

    Its amazingly hard to find a good back surgon. Ortho is a hard field. Its been my experiance that the best plan is to find a big pratice, and get a consultation with the most experianced doctor there, if you dont like what he says, ask him for a recomedation for a name. This worked well for my uncle. The second name is the one he went with, and he couldent have been happier. Doctors know other doctors work the best. (also, check out this artifical blood- it may revolutionize surgery – http://www.thenewsroom.com/details/333037/Health?c_id=wom-bc-kg – Kate from The Health Desk at TheNewsRoom.com )

  6. Hilary says:

    I have a herniated disk as well. I went through the physical therapy as well as the therapy in the pool. Both made it worse. I was afraid I was going to be back in bed. I was all ready to get the Cortisone shots, but I have a bleeding disorder so the hematologist didn’t want me to get that done or acupuncture. So, other than surgery, my last option was going to a chiropractor. The chiropractor has been awesome! I go to a place that offers specific chiropractic care. No cracking in the back, it is all done through the neck. They took a look at my MRIs and felt they could help me. And they have! Please contact me if you would like further information for the chiropractor that I go to. They are located in Massachusetts. Also, I am still careful with my physical activity; both exercise as well as lifting anything heavy.

  7. anon says:

    Spine-health.com has everything you need.

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  9. sylvia says:

    Don’t do lower back surgery unless you can’t walk. I’ve gone through three and the last one was for lower back pain. They worked on the lower 2 discs. I had foot drop and have had excruciating pain since. Try all your options but don’t do it, unless you’re crawling.

  10. robert west says:

    Before you go for back surgery, give acupuncture a try. I had my appointment for surgery, when a friend suggested I try acupuncture. After 10 treatments I no longer have back pain, I am even back to exercising now. If you are in Portland Oregon and want to try acupuncture for back pain go to http://www.portlandacupuncture.net

  11. Ken Warner says:

    I am considering having this nerve burning procedure done on my back. But from the little I have read it is not the answer or cure I am looking for. Has anyone had this done and what is your opinion. Please write this has taken away my every day life.
    Ken Warner

  12. Tami Neff says:

    I have moderate to severe disk degeneration at L4-L5 to L5-S1. I have trouble walking as my left leg goes out from under me at random. I can no longer work out at all so my former successful efforts at keeping a strong core have deteriorated. I will try an ESI to see if that helps but I realize it’s just a band aid. The only conventional solution is fusion but I am looking at a new laser surgery called PED that is performed by the Laser Spine Institute. Minimally invasive and amazing recovery. I have med journals to review but I’m looking for referrals from one who’s had the fusion surgery and also one who may have had the laser endoscopic surgery. I need my life back-I’m only 40.

  13. Georgia Bynum says:

    Minimally invasive treatment is an option for disc degeneration and lumbar stenosis. One of the least invasive available is AccuraScope (www.northamericanspine.com).

  14. Edward Duffey says:

    I had a herniated and a bulging disk in my back from a fall. I had back surgery in October of 2008 and it only slightly helped and I am in pain all the time, severe pain. The doctor told me he scraped about 30% of one of my disks to get it off of a nerve, but it still hits that nerve constanly and I am sure of it. I want the second option he gave me which was to remove the two disks and put in two plates and four screws. Can someone refer me to someone here in NC? I am embarrased to admit it, but thers a catch. I have been released by two different doctors because they found TCH in my urine tests. I am totally willing to kick the habit to get the care I need, but I need a referral. I have no income because of my injury, I cant work. Please help!!! edwardduffey3@yahoo.com Go ahead and mark off Dr.Richard Levi Boortz Marx from Chapel Hill Pain Clinic and from Cape Fear neurosurgery, Dr. Richard Osenbach(performed 1st surgery)Please e-mail me your answers? ty!! :)

  15. Martin says:

    This is a very important topic! Unfortunately, there is an all too common misconception that surgery is the only way to go in many cases. In fact, surgery should be a last ditch effort after all other options have been exhausted.
    Try acupunture, try massage therapy, or try chiropractic. A good local chiropractor can do a lot for pain management (in just a few visits) and get you on your way to better health, naturally.
    Would you rather your body begin to heal itself after removing misalignments in your spine, or would you rather get cut open?
    Check out http://www.thechiropracticblog.wordpress.com for lots of good info!

  16. Debra says:

    It’s surprising such a high percentage of people don’t seek non-surgical treatments first. Sometimes they work, but sometimes spine surgery is inevitable. Solutions can’t be rushed and there is no need to foolishly undergo surgery.

  17. james says:

    I would suggest you to meet the person who already had the surgery which you are going for and ask him whether he got relief from surgery and then you must take the decision of surgery .

  18. Thank you for your suggestion. I have seen him whether he got relief from his surgery. And you must take the decision of surgery.

  19. It is an option for disc degeneration and lumbar stenosis. One of the least invasive available is AccuraScope.

  20. Acupuncture is the practice of inserting needles into specific points on the body in order to solve physical ailments, illness, and pain. The basic premise of acupuncture is that the body will restore itself to health under the right circumstances. Acupuncture is a method of assisting the body to heal itself and restore itself to perfect health.

  21. Here are the several ways of method for Health related..!!

  22. They are useful in the hospital, as you will be encouraged to get up and walk around as much as tolerated soon after the surgery.

  23. The good news is chronic low back pain is one of the conditions that research suggests acupuncture may be an effective tool for treating.

  24. Until to this day i was waiting for this information..here i got it

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