Wednesday 27 June 2007

Is Disc Surgery Necessary?

The answer to the above question may surprise you, especially if you or someone you know faces the prospect of disc surgery. According to a paper in one of world’s leading spinal journals, in almost all cases it probably doesn’t need to be done.

The paper in Spine states that about 1% of the population will experience disc herniation each year and over 90% of them will improve without surgery using “conservative” care, that is without surgery. About 2-4% of patients with disc herniations have indications for surgery. Also an MRI will reveal a disc herniation in approximately 20% of asymptomatic patients aged less than 60 years. Meaning that about 20% of people have herniations and have no symptoms, no pain and no knowledge of disc problems. Therefore in many people, the existence of an MRI showing disc herniation doesn’t automatically mean the herniation is causing their spinal pain. The herniation may be concurrent or coincident with the pain.
But the article tells us something fascinating: “Over time, most patients with disc herniations recover with or without surgery, so that outcomes after five years are similar when surgical and non-surgical approaches are compared.… In the end, the decision to operate on a patient with a lumbar disc herniation usually depends on patient preference rather than necessity.”
Be aware that this study does not specifically include chiropractic care, which has saved many people from spinal disc surgery. Many of the thousands of disc operations done each year would be unnecessary if a “wait and see” approach were used. (But we’re sure even more would be saved from the knife if a “wait and see and chiropractic” approach were used. (2)

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