Patient Education: Diseases Conditions Treatments & Procedures
Back pain
Surgery of Back Pain
There is no more a controversial topic amongst spine surgeons than the surgical management of back pain. Surgery is indicated if there is any sign of instability (abnormal movement) in the spine. In the absence of instability, surgery can also be highly effective if the pain generator can be identified. This is not as easy as it seems. If the vast majority of pain is due to the muscles, then certainly fusion is not the answer. In the occasional patient though, the disc may be the culprit, but which disc is it? Is it the disc L3/4 or is it L4/5, or is it L5/S1. Surgeons have tried many ways to identify that pain generator with little success. But if identified with certainty, surgery may benefit you. So if your surgeon tells you he has good news for you, "you do not need surgery", this is most likely the fact he can not be sure of the pain generator and failed surgery (any which way) will leave you worse off than no surgery.
