It’s a fact that some spine surgeonshave higher success rates for the operations they perform than their colleagues. What accounts for these differences in surgical outcomes of spinal procedures? A number of factors influence surgical success rates and should be considered when interpreting what the rates say about a particular spinal surgeon’s abilities.
Spine surgery is a highly complex endeavor requiring years of training and experience to perfect. Surgeons with more experience tend to have more successful outcomes than less experienced surgeons. The success rates of board certified or board eligible spine surgeons are also typically higher than those of non-board certified or eligible surgeons. Another factor to consider: some surgeons specialize in specific areas of the spine – such as lumbar spinal surgery – and some specialize in treating particular conditions – such as slipped disc or spondylolisthesis – while other back surgeons do not specialize in any one type of treatment. Specialists have higher success rates than those of their colleagues who do not focus on the type of surgeries they perform.
Beyond the skill of the surgeon, success rates are also linked to the type of procedure chosen to treat a particular problem. The decision to utilize one procedure – perhaps because the surgeon is more familiar with it – rather than an alternative treatment, can also affect a surgeon’s success rate. For example, there is a choice in surgical stabilization procedures to employ following decompression spinal surgery, which is performed to treat conditions including spinal stenosis, spondylosis, and spinal cord injuries. In the past, spinal fusion back surgery has been virtually the only surgical stabilization option, but today an alternative procedure, the TOPS™ (Total Posterior Solution) System has been proven in clinical trials around the world to provide better success rates that spinal fusion. Thus, a back surgeon might have a better than average success rate performing spinal fusion procedures, but still not reach the success rates achieved with a new procedure. That’s why it’s important to be familiar with the full range of available treatment options when evaluating the success rates of any spine surgeon.
The last several years have seen great strides in developing advanced surgical solutions for spinal problems. Many of these advances involve minimally invasive procedures that leave surrounding tissue undisturbed, allowing faster recovery times and eliminating many of the complications associated with invasive back surgery operations.
Minimally invasive spine surgery is taken one step further by state-of-the-art miniaturized medical equipment, such as fiber optic cameras and microscopes. These procedures, often referred to asendoscopic spine surgery, lend themselves to treating a variety of spinal conditions and disorders including slipped disc and pinched nerves. These minimally invasive spine surgery procedures can remove tissue exerting pressure on nerve roots emanating from the spine, providing dramatic relief for back pain and restricted mobility. However, like any form of surgery, endoscopic spine surgery should be performed only if non-surgical treatment options have been exhausted and these restricted access techniques can adequately address the patients’ diseases. Conservative treatments include physical therapy, epidural injections, and medication to control pain and discomfort. If you and your physician conclude that endoscopic back surgery may be appropriate, the decision on which procedure is best should be made only after a thorough evaluation of all aspects of your case. In some situations where bone must be removed from a vertebra as part of the surgical procedure (as in a laminectomy or spinal decompression surgery procedure), the endoscopic procedure does not provide adequate access or visualization to perform a proper decompression. Suboptimal removal of pain generators, especially when followed by the fusion of adjacent vertebrae, can have adverse outcomes. Moreover, it is irreversible as spine fusion surgery eliminates the independent flexion and rotation of the fused vertebrae. But another advance of recent years, the TOPS™ System, has proven to provide a better clinical outcome than spinal fusion. An implant device, the TOPS, or Total Posterior Solution System, preserves the independent motion of the individual vertebrae.
If you suffer from back pain or other symptoms of spinal problems, don’t let outdated ideas about back surgery keep you from seeking treatment. Today a host of conservative treatments such as medication and physical therapy can often provide relief, and when surgery is called for, it can often be performed without complications.
Not all advances in treating spinal disorders are necessarily new. Acupuncture has been practiced for thousands of years, and researchers and medical experts have now established that this ancient healing art can relieve chronic back pain. One recent study funded by the National Institutes of Health found that acupuncture can be more effective than standard treatments such as medication or physical therapy for relieving back pain – even for conditions such as very mild incidents of spinal stenosis and slipped disc. In the study, patients were divided into four groups. In one group patients received customized acupuncture treatments. Another group received acupuncture treatments generally recommended by practitioners for chronic lower back pain. A third group received only a treatment that mimicked acupuncture, using a toothpick that never actually penetrated the skin. The fourth group simply continued the course of therapy they were already pursuing, without acupuncture.
Researchers found that all three of the acupuncture groups – even the simulated acupuncture group – reported more “meaningful” improvement in their ability to engage in everyday activities than did the group that continued their usual back pain therapy without acupuncture. Moreover, the study authors found that the superior improvements in pain reduction reported by the acupuncture group participants persisted after a year.
This study certainly doesn’t suggest everyone with spinal problems should stop their current treatment regimens in favor of acupuncture. After all, not all participants in the study benefited from acupuncture. But the study concluded that acupuncture is a reasonable option to be considered when selecting therapy for back pain. This is one more example of new thinking about treatments for chronic back pain, which has witnessed major advances in recent years. For example, spinal decompression surgery, which can dramatically reduce back pain by relieving pressure on pinched nerves emanating from the spinal column, was traditionally followed by spine fusion surgery, to stabilize the vertebral segments where the decompression procedure was performed. Today the TOPS™ (Total Posterior Solution) System can be implanted as an alternative to spinal fusion. Unlike spinal fusion, the TOPS solution allows the individual vertebrae to maintain their full range of independent motion.
If you have chronic back pain, make sure you know all the treatment options available – from acupuncture to spinal decompression surgery. And always work with qualified physicians specializing in spinal problems to find an appropriate treatment protocol.
Are some spinal surgeries more successful than others? The short answer is yes, but that doesn’t tell the entire story. Any spinal surgeon will tell you that every patient’s case is unique, and that post-operative recoveries and long-term outcomes also vary from patient to patient. In addition, every operation is different, whether dealing with a traumatic spinal cord injury of a degenerative condition like spinal stenosis. For that reason alone some spinal surgeries are more successful than others. Some patients may work harder at their recovery, while others may benefit from an extremely skilled surgeon. Patients don’t always define success in the same terms, and thus rate clinically identical outcomes differently. But beyond these differences in individual cases is the undeniable fact that some surgeries carry more risk or have a lower rate of clinical success than other procedures, and that some are proven to provide superior outcomes than others for treating the same condition. Spinal decompression surgery, a relatively common procedure, is an excellent example of differences in the success rates of spinal surgeries.
Spinal decompression is performed to relieve pressure on a nerve within or emanating from the spinal column, the cause of common back problems such as sciatica. The spinal decompression procedure, which involves cutting away portions of a vertebra impinging on a nerve, can dramatically reduce pain and restore mobility in many cases. However, the procedure leaves the vertebral segment weakened and in need of stabilization. Traditionally, spinal fusion surgery was performed in conjunction with spinal decompression therapy to stabilize the spine at the segment where the decompression was performed. Today the TOPS™ (Total Posterior Solution) System is available as an alternative to spinal fusion back surgery. In clinical studies around the world, the TOPS Solution has been found to deliver superior clinical outcomes than spinal fusion surgery. And that’s a definition of success in just about every patient’s and doctor’s book.
Whether a patient is having open back surgery for a spinal cord injury or a minimally invasive procedure for a condition such as a slipped disc or spinal stenosis, the operation itself is only the first part of a successful outcome. The post-surgical recovery period is critically important for long-term success, and the proper physical therapy program plays a large role in this process.
Patients for both open and minimally invasive back surgery will require physical therapy. Physical therapy strengthens the muscles in the back and helps heal the tissues in the area where the surgery was performed. In fact, back problems are often caused in part by muscle weakness. Even in otherwise well conditioned individuals, the back muscles around areas exhibiting spinal problems have been shown to be weaker than surrounding muscles, and weak muscles also contribute to poor spine and spinal joint functioning. Thus, one of the goals of post-operative therapy is to strengthen muscles that support the spine. Some of these muscles are in the back, but specific abdominal muscle groups also provide back support. Biofeedback devices can help patients learn how to activate, control and exercise these abdominal muscles, thereby strengthening them.
The amount of physical therapy required will vary based on the procedure performed, and this is one area where surgical options are important to consider. For example, patients undergoing spinal decompression surgery typically have a secondary procedure performed in conjunction in order to stabilize the vertebral segments where the spinal decompression was performed. This secondary operation following the spinal decompression procedure may be spinal fusion or the TOPS™ (Total Posterior Solution) implant. The TOPS Solution preserves the full range of motion of individual vertebra whereas spinal fusion surgery eliminates this independent movement. More important from a recovery perspective, The TOPS solution places no restrictions on patients. You can do whatever you feel like pursuing.
The amount of physical therapy required after spinal surgery will vary from patient to patient, and from procedure to procedure. Make sure you’re aware of the physical therapy associated with the procedure you’re considering.
Lower back pain is one of the most common medical problems affecting the human population. One reason this problem is so common is because back pain can have many different causes. So if you’re wondering if there’s a cure for your lower back pain, the answer depends on what is causing it. Muscle and ligament strains can cause intense back pain. Many times these strains can be cured with simple rest. Where rest alone won’t relieve the back pain, non-invasive treatments such as medications, steroidal injections, and physical therapy will often ameliorate the symptoms, if not provide an outright cure. For spinal conditions such as spinal stenosis and related disorders of the spine – common causes of lower back pain, with onset typically after the age of 35 – non-invasive treatments may also provide relief. In some cases decompression spinal surgery may be performed to relieve pressure on affected spinal nerves. During this surgery, a surgeon trims away portions of a vertebra that impinge on a nerve. (This impingement is commonly referred to as a pinched nerve.) Spinal decompression surgery can have a dramatic and immediate impact on reducing back pain, providing patients with some level of a “cure.” Traditionally spinal fusion back surgery has been performed in conjunction with spinal decompression, to stabilize the vertebrae where the operation was performed. But spinal fusion eliminates the natural flexion between the fused vertebrae, and can contribute to deterioration of adjacent vertebrae. Today spinal decompression patients have a superior alternative to spinal fusion. The TOPS System from Premia Spine preserves the natural motion of the spine, and has been proven to provide superior results to spinal fusion in clinical trials conducted worldwide.
If you experience lower back pain, the first priority is to identify its cause. Whatever the root of the problem, you will likely have a number of options for effective treatment that will relieve the pain, and in many cases cure the condition.