According to statistics from the American Chiropractic Association, up to 80% of adults will experience back pain at some point in their life. That back pain accounts for more than 264 million missed workdays a year and is the third most common reason for doctor visits. Our backs are a complicated system of bones, ligaments, joints and muscles — with the spine at the center of it all. When you have back pain, pinpointing the issue and choosing a treatment path requires careful consideration.
If you’re experiencing back pain that stems from your spine, you want to find answers that allow you to return to normal life. After failed non-surgical attempts at recovery, you may consider spine surgery. Back surgery is an ideal solution for some people, but it may not be the right fit for everyone. The following is helpful information to consider when deciding if back surgery could be for you.
The answer to the question, “Is lower back surgery dangerous?” is both yes and no. Every surgical procedure has risks, including spinal surgery. The nature of spinal surgery increases the risk of severe complications compared to other procedures. Spinal surgery happens at and around sensitive areas in the spine and spinal cord. The most significant risks you could face if an error occurs during surgery include paralysis or a spinal infection.
Despite the possibility of severe complications, the mortality rate for spinal surgeries is low. One study found a mortality rate of 0.13% out of 803,949 lumbar spine surgery patients. The rate of surgical complications is also low, with a 7.6% complication rate in a study of 3,475 patients. Your back surgery may deviate from standard risk levels, depending on your existing health conditions and the type of surgery you’re having.
Much of the potential danger in a spinal surgery links to the potential bodily risks if something goes wrong during the procedure. The spine and spinal cord play pivotal roles in bodily strength, sensation and movement. Mistakes or complications during surgery could impair one or more of these functions. In addition to these dangers, a more involved surgical procedure could present more significant risks than a simple procedure.
Aside from danger, one of the paramount concerns for back surgery is whether or not it is successful.
One study estimated the success rate for back surgeries to be about 50%. This estimate is conservative, as most success rates depend on a wide variety of factors. Your health, specific surgery, source of pain and any surgery complications influence whether or not your procedure will be effective.
The American Society of Anesthesiologists estimates that 20 to 40% of back surgeries fail. Patients having repeated back surgeries have a much higher chance of failure. One study found only 30% of second back surgeries are successful. The number decreases for third and fourth back surgeries, with a 15% and 5% success rate, respectively.
Unfortunately, failed back surgery is common enough that it has received classification as a medical condition. Failed back surgery syndrome (FBSS) occurs when a patient experiences continued pain in the back, neck or limbs following a surgery meant to reduce pain.
Failed back surgery is relatively common — but not because the surgeon performed the procedure incorrectly. Back surgery can only accomplish two goals: decompressing a pinched nerve root or stabilizing a painful joint. If a pinched nerve or painful joint is the source of a patient’s pain, a doctor may be able to address the issue with surgery.
However, it can be challenging to identify and diagnose one of these factors before surgery. One of the most common reasons back surgery doesn’t work is because the surgery selected does not address the source of a patient’s pain. Considering appropriate non-surgical measures before surgery can help you avoid a costly procedure that does not adequately address back pain.
Though the complication rate for back surgeries is relatively low, there is still potential for a variety of health issues. The following are some common complications to consider.
You may be less likely to experience specific complications based on your health condition. Talk to your doctor to learn about a list of complications that could be pertinent to you following a spinal surgery.
As mentioned before, several factors impact spinal surgery success rates. Your surgery method, the condition you’re attempting to fix, your surgeon, aftercare plan and more play into the results you may experience. For example, your low back surgery success rate may vary, depending on whether your low back pain stems from a pinched nerve or herniated disc.
Though the percentages given in this section indicate general success rates, you’ll need to talk to your surgeon to determine a projected success rate for your unique situation.
The thoracic spine is in the middle of the spine, between the abdomen and upper back. You may have thoracic spine surgery if you’ve severely herniated a thoracic disc or if you have one of the following conditions:
According to one study, patients who had thoracic spine surgeries with the posterolateral approach had a complication rate of 12 to 30%. After 17 months of recovery, 76.9% of these patients reported satisfaction with the success of their surgery.
A surgeon might use minimally invasive spine surgery (MIS) to stabilize vertebrae and spinal joints or relieve pressure on spinal nerves. This approach is a more conservative method compared to other open spine surgeries. Surgeons use small incisions, microscopic video cameras and guiding instruments to minimize the amount of trauma to the surgery site.
You may qualify for MIS if you have one of the following conditions:
There are several types of MIS procedures, depending on where a surgeon makes their incision. For an MIS transforaminal lumbar interbody fusion, success rates range from 60 to 70%, with an 80% satisfaction rate for patients. For an MIS posterior lumbar interbody fusion procedure, patients experienced a 90 to 95% successful fusion rate.
Herniated discs are common in the lumbar spine, but they may also occur in the cervical spine near the neck. If your discs have degenerated with time and ruptured, you may require herniated disc surgery. Depending on the location of your herniated disc, you may require a different surgical procedure.
According to one study, the success rate for a herniated lumbar disc surgery was 78.9% among 39,048 patients. This same study reported a 94% long-term success rate for patients undergoing herniated cervical disc surgery.
Several spinal fusion surgeries can help limit back pain that stems from specific points. A fusion surgery involves joining two vertebrae with a bone graft, so they become one solid bone. This procedure can give your spine more stability and address pain you may feel when moving.
You may consider a spinal fusion surgery if you have one of the following conditions:
Depending on the condition the surgery is treating, spinal fusion has a 70 to 90% success rate.
Sciatica occurs when you feel sudden pain in your hip and lower back that radiates to the back of the leg and thigh. You may experience sciatica as a result of normal wear and tear that accompanies aging. About 80 to 90% of individuals with sciatica will experience relief without the need for surgery. However, sciatica surgery may be appropriate if you feel disabling leg pain even after non-surgical intervention.
If most of your sciatica pain is in your legs, there is a 90% surgery success rate with a laminotomy and discectomy.
If most back surgeries have a greater than 50% average success rate, why is FBBS an issue? The answer is that most back surgeries rely on a variety of factors for success. These include patient health, the type of spine surgery a patient has and the way post-operative factors play out.
Your health may influence the rate and success at which you recover. According to one study, the following conditions could negatively affect back surgery success:
If the surgical method used is not appropriate to address a patient’s pain, they will likely have a higher risk of back surgery failure. If there are any errors or complications during the operation, the surgery may have a greater risk of failure as well.
Back surgeries may not be as successful if a patient has one of the following conditions soon after surgery:
Surgery may also have decreased effectiveness if a patient experiences transition syndrome as they recover.
Before you consider back surgery, doctors typically recommend you try conservative, non-surgical options. Most physicians suggest a three-month time window for these options, as many back issues will resolve themselves after that time. If you’ve completed non-surgical intervention and still struggle with back pain, you may want to talk to your doctor about surgery.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases recommends surgery in the following situations:
Whether you fall into one of the above categories or not, there are several crucial questions to consider before pursuing surgery:
No matter your situation, treatment options range from general to specific. Talk to your doctor to determine what may be appropriate for your back pain.
Before having back surgery, non-surgical treatments like the following can help mitigate or completely relieve your pain.
If you still feel severe pain after three months of non-surgical intervention, you may want to consider surgery. Depending on where you’re experiencing pain and what is causing that pain, there are several surgical methods available.
If you’re struggling with back pain and you’re not sure what to do next, talk to the experts at OrthoBethesda. We have committed to taking a conservative approach for treating back and spinal issues, and we can guide you through a safe and effective treatment progression.
Our physical therapists will work with you to establish a physical therapy or injection plan before you consider surgery. If surgery is the best option after non-surgical treatment, our skilled surgeons will meticulously choose and carry out an effective surgery plan. For more information about how you can find relief, contact us today.