Reasons Why a Patient May Need Back Surgery

Reasons Why a Patient May Need Back Surgery

If you are one of the millions of American adults who experience back pain, you may be wondering if back surgery may be right for you. Surprisingly, many experts estimate that back surgery is only necessary for about 5 percent of the people who suffer from back problems.  In fact, although back surgery can be extremely helpful under specific circumstances, under the wrong conditions, surgery may only escalate your pain.

Before considering surgery, patients should first receive a thorough examination to locate the source of their pain and then carefully research and participate in non-surgical treatment options.  Many patients find relief through anti-inflammatory medications, physical therapy and exercise, ice, heat, epidural injections, spinal manipulation, acupuncture, and massage.  Multidisciplinary spine and pain programs like the Spine Center at the Dartmouth-Hitchcock Medical Center and the Texas Back Institute offer intensive programs that help patients build up their strength and regain mobility while teaching them effective ways to cope with pain including meditation and biofeedback.

When is back surgery warranted?

Broadly speaking, when your pain does not respond to more conservative treatments, there are two main reasons to undergo back surgery: compression of a nerve and arthritis in the vertebral column.  Read on for a more detailed discussion of the conditions that may necessitate back surgery.

  1. Compressed nerves.  A pinched nerve in your spine can be caused by a variety of conditions including bone spurs and slipped disks and can result in intense pain in your back and numbness in the back of the leg.
  2. Herniated disks.  Intervertebral disks are rubbery rings with jelly-like centers that cushion the vertebrae.  They may slip out of place or rupture due to injury and cause sharp pain, weakness and numbness.  Some people with herniated disks experience no pain.  In other cases, a herniated disk may irritate and inflame the nerve, a condition called radiculopathy,
  3. Vertebral fractures.  Broken bones in your back may be caused by injury or osteoporosis (a condition involving the loss of bone density).  Fractured vertebrae frequently heal on their own, but if they render your spine unstable, they may need to be repaired surgically through vertebral fusion.
  4. Bone deformities.  Certain deformities and other conditions may necessitate surgery in severe cases, including scoliosis (curvature of the spine) and kyphosis (a humpback deformity of the thoracic spine).  Spondylolisthesis is a condition in which part of the spine slips out of position onto the section beneath it.  It may be caused by a birth defect, acute injury, or arthritis and may require surgery in extremely painful cases.
  5. Spinal stenosis.  Spinal stenosis occurs when the spinal canal narrows, constricting the spinal cord and the openings through which the spinal nerves travel.  It is frequently caused by aging and arthritis but may also be due to injury, bone disease, congenital defect, or tumor.
  6. Degenerative disk disease.  Backs experience a lot of wear and tear during a typical life span and may develop pain as they age.

The good news is that, with good self-care, many episodes of back pain resolve themselves after about 6 weeks.  However, if your pain is severe or if you are experiencing any of the following symptoms—extreme nighttime pain, pain that intensifies when lying down, weight loss, fever, or bowel or bladder dysfunction—you should not hesitate to contact a well-qualified health care provider who can identify the source of your pain and help you understand both your surgical and non-surgical treatment options.

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