I first posted this on the old forum so thought it might be helpful to some people now on the new forum.
Many people question surgery and wonder what the advantages and disadvantages are. I have summarized below what I think are the pros and cons of surgery but I want to state that these are only my views as a long time back pain sufferer who has had two surgeries and is now back-pain free. Please just use this as an additional source of information in your information-gathering exercise but at the end of the day you should make a decision based upon what you and your doctor(s) agree is best for you.
In my mind, surgery should always be seen as last resort as it is usually irreversible.
(Not all of the following pro’s and con’s apply in every case)
- Remove completely, or significantly reduce, current pain levels. This is thought of or recognised as the most obvious reason for having surgery but it may not always be achieved, however the following point must also be considered – the two really go hand in hand.
- Stop the condition from getting worse and causing increased pain or disability. This is often overlooked but is a significant benefit of many spine surgeries. For example, DDD resulting in foraminal stenosis, a fusion ‘fixes or locks’ the fused joint (stabilises the joint) so that any further disc degeneration will not cause the stenosis to come back.
- Removing the risk of permanent nerve damage, if the condition is impinging a nerve. Conditions which impinge a nerve can cause permanent nerve damage if the condition persists for too long. Surgery will remove the nerve impingement thus remove the risk of permanent nerve damage.
- Fix a structural deformity, e.g. scoliosis. Usually there are no other options for significant deformities, other than surgery.
- Lengthy recovery period. For most of us, the recovery period from spine surgery is longer than we ever imagined. It is common for patients to be off work for many weeks to several months, and for full recovery to take up to a year or more.
- There are no guarantees that the surgery will reduce your pain, although there is a very good chance. However, don’t expect to feel 100% perfect again, especially if it is major surgery like a fusion.
-There is a small risk of increased pain/complications – things can go wrong, or your condition could be far worse than thought before surgery. Occasionally, patient’s pain levels are worse after surgery than before.
- In case of fusion surgery, additional stresses can be placed on adjacent discs – this slightly increases the risk of problems with those discs in the future.
- Standard surgical risks associated with any surgery.
- Expensive (not a problem if your insurance is paying).
For the right condition, at the right time, surgery is absolutely appropriate and can give back a quality of life that was not possible by other conservative pain management options. However, surgeries can also be performed on patients when surgery is not the most appropriate treatment option – sometimes with terrible outcomes. This does happen.
The decision to have surgery or not, is not an easy one and all the other associated points commonly talked about on this message board should be considered, e.g. getting second opinions, exhausting conservative pain management options first, etc. Do your research / due diligence.
Additional comments welcomed...
...an old timer here and ex-moderator