Surgery Results Very Disappointing
According to a story from the April, 8, 2002 issue of the New Yorker online magazine "Fact", the results of back surgeries performed over the years have been much less than expected. The article starts by asking the question, "Is surgery the best approach to chronic back pain?" It then goes on to state, "Last year, approximately a hundred and fifty thousand lower-lumbar spinal fusions were performed in the United States."
When asked about the chances for success with spinal surgery, Dr. Eugene Carragee, at Stanford, who says he performs the operation only on a select group of patients who have been carefully screened, estimates that less than a quarter of the operations will be completely successful. For the majority of patients, the surgery does not have a dramatic impact on either their pain or their mobility. He concludes, that the patient's prospects for a future that is free from back pain is fairly poor.
The New Yorker article also states that many patients who have had surgery end up going back to their surgeons. In a study in the state of Washington of workers injured on the job who received fusions for degenerative-disk disease, the results showed that twenty-two per cent had further surgery. The article also reported that Dr. Seth Waldman, at New York's Hospital for Special Surgery, claims to regularly see spinal-fusion patients who experience persistent pain after multiple operations. Sadly, few patients facing spinal surgery seem to have any idea that the statistics are so unfavorable.
In the December 2001 issue, the journal "Spine" published the results of an award-winning study from Scandinavia in which patients who underwent fusion surgery for chronic lower-back pain were compared with those who had had no surgery. In this randomized controlled trial, only one out of every six of the patients in the surgical group was rated by an independent observer as having an "excellent" result after two years. Additionally, Dr. Richard Deyo, an internist and an expert on back pain at the University of Washington, recently published a statistical analysis of existing research which suggested that spinal fusion generally lacked scientific rationale, and also that it had a significantly higher rate of complication than did discectomy.
In conclusion, the article quotes Dr. Seth Waldman, who sees the consequences of failed fusions at the Hospital for Special Surgery every week. Dr. Waldman wishes that the medical profession could be persuaded to show a little restraint. He concludes the article by saying. "If you have a screwdriver, everything looks like a screw. There will be a lot of people doing the wrong thing for back pain for a long time, until we finally figure it out. I just hope that we don't hurt too many people in the process."
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