Many individuals present to our office with preconceived opinions regarding neck, back or spine surgery. Friends or family members may have shared second-hand stories with these individuals, sometimes recalling less than desirable outcomes. While surgery is certainly not indicated for everyone, the right procedure done for the right condition on the right patient can produce dramatic and satisfying results.
So what is the right procedure or the right condition?
To begin, an evaluation of a neck, back or spine condition entails a complete history and physical exam, as well as a review of any imaging studies. It is important to correlate a patient’s symptoms with objective findings and imaging abnormalities in order to arrive at an accurate diagnosis. Often times, there are findings on an imaging study that do not correlate with a patient’s symptoms, and therefore are considered “incidental”. These incidental findings often do not require any specific treatment. Delineating the exact etiology of a patient’s symptoms is the most important initial step in the treatment process. Once that diagnosis is made, various treatment options can then be entertained. These options are based upon literature supported studies, indicating statistical benefit for a specific treatment. From this, we derive the right procedure for the right condition.
Who, then, is the right patient?
Many patients with neck and/or back conditions can be treated non-operatively. Suggested modalities may include such things as activity modification, medication, physical therapy, epidural steroid injections, etc. Persistent pain and neurologic symptoms that remain despite conservative treatment, and substantially interfere with one’s lifestyle, may be amenable to surgical intervention. Those individuals who fail to improve with non-operative treatment, and who demonstrate symptoms and signs consistent with abnormal findings present on imaging studies, then become the right patient.
Potential conditions that may benefit from surgical intervention include:
- Herniated discs
- Spinal stenosis
- Spondylolisthesis (abnormal slippage of the spine)
- Spondylosis (arthritis)
In summary, most spinal conditions improve with non-operative treatment; and giving your body time to heal itself often resolves many ailments. For those individuals who fail to improve with non-operative treatment, surgical intervention can substantially improve their condition. However, the surgeon must choose the right procedure for the right condition on the right patient in order to have an optimal outcome.