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Back 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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