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  • Dr. J

Is Spine Surgery your Best Option?

Updated: Dec 2, 2021





So...

SPINE SURGERY


Worth it?


Short answer: In most cases, NO.


Of course, there's a time and place. And thank goodness for the newer technologies to help as a last resort when needed. But for most people, resorting to surgery should NOT be the first, or second, or third... etc.. option.


Which, is supported by the research,

and, as I've found out from talking with hundreds of people in this position...

also aligns with your intuition.




You've checked off the list:


  • Chronic pain

  • Hasn't gotten better over time

  • Ibuprofen just wasn't doing the trick anymore

  • Those stretches the PT gave you aren't working

  • Your family doc referred you over to get Xrays

  • 'Nothings wrong! A little degeneration. So we should get an MRI, just to make sure'

  • MRI shows some disc issues.

  • Let's start with an injection. This should numb things up. Come back in 3 months.

  • 3 sets of injections, and the pain is still there.

  • Let's get some more imaging

  • And talk about surgery.



Typical story.

I've heard it, countless times from people I've met out in the community, as well as those who have come into my office.


For good reason, as 80+% of the population will experience chronic back pain at some point in life, and is the #1 reason for occupational injury and disability.




Unfortunately, this is the process that so many go through. Not only do these measly processes rarely produce positive results at the beginning to get an individual better... but it prolongs the actual healing process and people are left in no better condition than when they started seeking 'treatment'. From a conventional standpoint, there's no true direction to help a person understand what's causing the issues, and more importantly, what can be done to correct them without drugs or surgery.


No clear answers.

No direction.

No hope.


Yes, they may receive 'treatment', but they don't receive CORRECTION, HEALING, AND RESOLUTION.

-Dr. Justin Lee D.C



There is a vast difference between treating symptoms... and correcting CAUSES.

By treating the cause of any issue, the underlying issue can be corrected, and the body will function better, and ultimately heal. Simply put, this is how you actually get healthy.



Of course, there is a time and place for surgery and other procedures (yes, it had to be repeated). In a life saving emergency, and when there is considerable damage and ALL other options have been exhausted. These are the moments where, thank God, we do have emergency medicine and the best specialists on the planet, with the best technology. I have friends and colleagues that work in this industry, and I'm so grateful for many of the amazing things they do.


But, drugs and surgery are not the first and only option for most. And it should not be touted as the gold standard in addressing spine dysfunction and pain.



 


Spine Fusion Surgery: The Verdict


According to Dr. Ian Harris, a world renowned orthopedic surgeon, professor, and researcher; "There is very little evidence that spine fusion surgery for back pain is effective. It is quite expensive, often leads to complications, often requires further surgery, is associated with increased mortality, and often does not even result in the spine being fused."


"Millions of people have had spine fusions for back pain, and I am not at all convinced that the benefits of this surgery outweighs the considerable harm."
"Somebody is winning here, and it isn't the patients."

-Dr. Ian Harris




650,000-700,000 Spine surgeries per year.


  • From 2004-2015, Volume of elective lumbar fusion increased 62.3%.

  • In the same period, Aggregate hospital costs increased 177% during these 12 years, exceeding $10 billion in 2015, and averaging more than $50,000 per admission.

  • $40+Billion industry in treatment costs/year

  • Average cost of $100,000

  • Work loss, disability, indirect costs=$100-200 billion/year

  • 149 million work days lost.

  • 3 million people went to the emergency room in 2008=$9.5 billion (9th most expensive condition treated in U.S hospitals).

  • The U.S has the highest spinal surgery rate in the world; 200% higher than New Zealand, and 340% higher than the U.K. Rates are similar in Canada, Australia, Norway, and Finland. Neck and back pain rates are similar amongst these regions.

  • FDA: 50% of single level degenerative disc disease fuion and arthroplasty were a sucess

20% of lumbar spinal fuion patients underwent 2nd surgeries.

Other studies show 28%.

  • Most common cause of death after surgery? Opiod addiction/overdose.

  • Some research suggest as high as 90% of spine surgeries are unnecessary.




Numerous other studies, even within the orthopedic or neurological profession, support the glaring fact that spine surgery is not the best option for low back pain. In fact, most report that it should be used as a very last resort.


"The National Institute for Health and Care Excellence has issued guidelines that state fusion for non-specific low back pain should only be performed as part of a randomised controlled trial, and that lumbar disc replacement should not be performed. Thus, spinal fusion and disc replacement will no longer be routine forms of treatment for patients with low back pain. This annotation considers the evidence upon which these guidelines are based."

-PMID: 28768775


Comparison of spinal fusion and nonoperative treatment in patients with chronic low back pain: long-term follow-up of three randomized controlled trials

Conclusion: After an average of 11 years follow-up, there was no difference in patient self-rated outcomes between fusion and multidisciplinary cognitive-behavioral and exercise rehabilitation for cLBP. The results suggest that, given the increased risks of surgery and the lack of deterioration in nonoperative outcomes over time, the use of lumbar fusion in cLBP patients should not be favored in health care systems where multidisciplinary cognitive-behavioral and exercise rehabilitation programmes are available.

-The Spine Journal: Vol.13 Iss.11




Risks Associated with Spinal Surgery


Adverse events are NOT uncommon.

In fact, they're remarkably common.


Multiple independent medical research teams have shown that reoperation rates are greater than 22%.


Again, there is a time and place for medical intervention... but it's not every time. And any time it's in question, other options should be explored. It's important to get a full view perspective of all factors that could be affecting the situation. Chances are, your spine doesn't NEED surgical intervention... proper alignment, motion, and function is more than a likely place to start. It's a necessity for everyone.


 


Get to the CAUSE


To get to the cause, we start with:


  • Comprehensive Consultation

  • Functional Assessment

  • Specific Digital Xrays


I LOVE being able to provide this insight for people as it empowers people to not just understand what is going on with their health, but to take action and correct issues that have been plaguing them for years.


From a specific analysis of your spine, we will be able to determine how well your spine in functioning, the specific alignment of the spine from various viewpoints, and the best approach to improve, and even correct any underlying misalignments and dysfunctional areas that are causing you issues.


This typically requires a specific corrective plan for each individual, which would include both specific treatments and adjustments in the office, as well as corrective spinal exercises at home. Reassessments are done throughout the process, and most individuals will receive an updated set of Xrays to quantitatively assess structural improvements with their spine.


The outcome?


Improved spine function.


Which leads to better movement, range of motion, less restriction throughout the spine/hips/pelvis/extremities. These are the traditional benefits from a biomechanics standpoint.

Neurologically, there are many other benefits as well. Which, physiologically speaking, are more important than the improved biomechanics. Improving your nervous system function will inevitably improve the overall health of your body. Every system of your body in fact. Because every system is controlled directly, and/or indirectly by your nervous system.


These are the side effects.


Once your nervous system is able to properly communicate with the rest of your body, everything will come into better balance; allowing your system to heal more effectively.


We consistently hear about improved:

  • Stress response

  • Heart rate variability (HRV)