Unnecessary spine surgeries on the rise

[AUGGIE]

What is the general consensus around here regarding this?

http://news.yahoo.com/s/ap/20100407/ap_on_he_me/us_med_back_surgery

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[AUGGIE]

/tumbleweeds/

 

[irie]

Why don't you just use this thread to post your side of the argument you were hoping to have?

 

[rcheeley]

I'm assuming this is a link to the article in Spine journal.

I'm a Physical Therapist, and I was just curious about the surgeons reaction to this? Obviously I'm for PT under certain (most) circumstances prior to going the surgery route, but understand that surgery in some cases is necessary and will eventually be required.

 

[DHT]

I think most surgeons agree that a trial of physical therapy and NSAIDS is prudent for most patients prior to surgery unless progressive neurological decline or cauda equina syndrome are present.

I can't read the article because the link is dead and I also don't know what kind of spine surgery they are referring to.

 

[rcheeley]

If it's the link to the article in the Spine Journal, then it's regarding spinal fusions.

But I would agree, I think PT should be given a chance if nothing else, even it is "believed" it will not work.

I couldn't tell you how many patients I've seen following a surgery that never did PT prior to the surgery, many of which did not report a significant amount of pain or any symptoms that may indicate the need for surgery right away, etc. Some of these patients actually were reporting a worsening of symptoms following surgery.

 

[bedrock]

I couldn't tell you how many patients I've seen following a surgery that never did PT prior to the surgery, many of which did not report a significant amount of pain or any symptoms that may indicate the need for surgery right away, etc. Some of these patients actually were reporting a worsening of symptoms following surgery.

Unfortunately, it varies greatly between surgeons. Some spine surgeons are conscientious about prescribing appropriate PT, NSAIDs, and non-surgical interventions such as epidural steroids or facet blocks before operating. Sadly, many spine surgeons are more focused more on their next mortgage payment and just directly set patients up for surgery.

 

[rcheeley]

Unfortunately, it varies greatly between surgeons. Some spine surgeons are conscientious about prescribing appropriate PT, NSAIDs, and non-surgical interventions such as epidural steroids or facet blocks before operating. Sadly, many spine surgeons are more focused more on their next mortgage payment and just directly set patients up for surgery.

I have always questioned the reasoning for "jumping" straight into surgery, and no one can read the mind of each surgeon, so I'd like have to more feedback from some if I could.

I do understand, that as a surgeon, obviously you're trained for surgery, and of course that is going to be what you recommend/advise. Just like I would recommend everyone have at least a PT evaluation to determine if they're appropriate (or would benefit) from it.

My biggest concern however, is that many people who end up having surgery, many of the reasons they are having back pain is not due to their pathology, but to their secondary symptoms such as back spasms. Even if someone specifically needed surgery, I think 2 weeks of PT pre-surgery would be great to help w/ their post-surgical outcomes.

Manual therapy techniques to relieve spasms, spine stabilization ex's such as abdominal bracing, and postural training to prevent further injury.