Will Spine Surgery Get Rid of All My Back Pain?

spinal stenosis

In the world of back surgery, there are what are called "home run" procedures and then there are sometimes "strike outs".

It can be extremely difficult to eliminate all of a person's pain at times. Surgery for leg pain from a herniated disc is a very successful operation for eliminating the leg pain, but not back pain. The same is typical for surgery for spinal stenosis. A laminectomy is a very good operation for leg pain, but does not help much with leg pain. In fact, a typical complication in 50% of patients after a laminectomy is resultant back stiffness and pain.

Surgery for a degenerative disc, however, is a different story. Studies looking at artificial disc replacement versus spinal fusions for degenerative disc disease showed that even with successful outcomes, 50% of patients still required narcotic pain medication for their back pain. That should be considered somewhere between a strike out and a home run, we'll call it a ground rule double.

If a surgery is of considerable magnitude, such as an adult degenerative scoliosis operation, complication rates approach 70%. Success rates are usually over 75%, but looking at the complication profile the decision for surgery needs to be made very carefully. Has the patient tried physical therapy? What about chiropractic treatment, pain management injections like facet injections, spinal decompression therapy, pain medications? Older individuals do not have the physiologic reserve as teens having scoliosis surgery.

Getting rid of all pain with adult degenerative scoliosis surgery is next to impossible. Anything over 50% should be considered a success and over 75% - Home Run.

It is actually possible after spine surgery to end up in more pain than where you started. Reasons for this may include the right surgery being done for the wrong reason, technical complication causing more pain, failure of the body to heal such as a non-fusion occurring, or a medical complication. Also, after a successful spine surgery one may end up later with an adjacent level problem such as with a fusion where the stresses go up or down and can cause problems.

The bottom line here is that spine surgery success rates vary widely. Prior to deciding on elective spine surgery, conservative treatment should be considered including pain management, spinal decompression, physical therapy, chiropractor treatment, spinal injections, etc. You may regret not trying those if the outcome is less than a Home Run.