Surgery for Low Back Pain: A Comprehensive Overview

By | March 6, 2015

The decision to operate on a lumbar disc herniation is not so much made on the basis of size as on the advantages and possible complications of a particular type of surgery.  Without a reasonable knowledge of the pros and cons of surgery an intelligent decision cannot be made.

The decision to operate on a lumbar disc herniation is not so much made on the basis of size as on the advantages and possible complications of a particular type of surgery. Without a reasonable knowledge of the pros and cons of surgery an intelligent decision cannot be made.

I would like to introduce our second new set of blogs, this one dealing with the surgical treatment of low back pain because when we come to questions of therapy we will find that surgery and conservative therapy are often just different sides of the same coin. We have dealt with the subject of surgery for low back pain many times before and in a number of places, but never in a comprehensive way. Surgery is not a one size fits all proposition. Operations come in different sizes, have different likelihoods of success, have different post-operative courses and are associated with different risks of both immediate and long-term complications. As such it is difficult for the patient to where he or she may stand with respect to diagnosis, treatment, recovery and complications. In this series of blogs I will attempt to discuss the major diagnosis groups and the types of surgery that are currently being used to treat them. We will start with an overview of the normal anatomy of the lumbar spine and then move on to the most common derangements of that normal anatomy. We will attempt to categorize the different operations both in terms of the degree of invasiveness and thereby the type and length of recovery but also the relative likelihood of success, failure and long-term complications. Finally we will look at Game Theory and the factors that might lead two different patients here at Schlesinger Pain Centers with similar problems to make two different decisions with respect to surgical therapy.


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