The Butchery of Back Surgery

By Michael Dorausch, D.C.

This week’s New Yorker magazine features an in-depth article on surgery of the low back, the politics associated with the procedure, and the fact that the results have been overwhelmingly unsuccessful.

To put the concept of low back surgery into perspective, the article begins by reminding us of several surgically touted procedures from the mid to late 1900s that ultimately proved to be disappointing. Once popular surgeries such as radical mastectomies and the tying off of arteries to increase blood flow to the heart were compared to the approximate 150,000 lower lumbar spinal fusions performed in the United States last year.

According to the New Yorker, roughly two-thirds of all Americans will experience significant lower back pain at least once during their lives. It is estimated, in the United States, that the cost of medical care for those who have been disabled by severe back pain ranges from $30 to $70 billion annually. Many Americans suffering from chronic lower back pain are told that fusion surgery is the solution.

The article goes into great detail about the failed procedure. It includes the story of a woman in her mid-30s who developed sciatica and her path down the surgical route. In this case, the individual was given Percocet (a very potent and sometimes addictive pain reliever) and was told to stop working. That was followed by epidural steroid injections, a discectomy, a discography, several MRIs, and finally fusion of the lower spine. The bones of the lower back were mechanically braced with metal rods, screws, and bone grafts.

According to the article, the individual was under the impression that the procedures the surgeon recommended were necessary and were validated by research. However, the article clearly states that had this individual explored the medical literature, she would have discovered that every aspect of her case: the interpretation of her MRI scan, the diagnosis made, and the rationale for fusing her spine, was controversial among spinal specialists.

This individual was contacted nine months later. She stated she was actually in worse pain than before the operation, the sciatica had returned, she could not go back to work, and the pain prevents her from sitting, driving, or walking for extended periods of time. She is 35 years old. (Every one of us knows at least one person like this, it is a shame.)

There is so much detail in the article that it would not do it justice to just read what is here. Visit the New Yorker website (link below) and/or go our and get a copy of the publication. The article ends with a quote from a medical doctor talking about others in his field. He states, “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.”

The New Yorker: A KNIFE IN THE BACK Is surgery the best approach to chronic back pain?