When is Spinal Surgery Necessary?

You’ve probably heard of a friend or a loved one who’s back pain resulted in a spinal fusion surgery. but you may not understand what prompted spinal surgery over non-surgical approaches, including chiropractic care or non-surgical spinal decompression therapy.

Simply put, spinal fusion is a surgical technique that aims to eliminate excessive motion (spinal instability) and nerve compression in the spine by fusing two or more vertebrae (spinal bones) together. Fractures and ligament over-stretching related to spinal trauma are a common reason for spinal instability, but excessive motion can also be caused by conditions such as spondylolisthesis (when one vertebra slides forward on another) and degenerative conditions where old injuries failed to heal properly.

When is spinal fusion necessary?

In the most emergency of situations is when a neurological injury such as cauda equina syndrome (loss of bladder or bowel function from a spinal cord injury), or loss of leg movement (paralysis) due to spinal nerve injury. The most ideal answer is after every non-surgical option fails to result with satisfactory results. A more comprehensive answer is failed non-surgical care, failed prior surgical care, x-ray evidence of spinal instability with neurological symptoms, and unremitting pain that is not controllable with pain management or non-surgical treatments. Treatment guidelines are not always followed, as many patients consult with a doctor of chiropractic only after they’ve already been advised that their lower back condition requires surgery.

The good news is that most conditions of the lower back can be managed with non-surgical chiropractic care (especially if combined with non-surgical spinal decompression and physiotherapy). With any musculoskeletal injury, it’s almost always best to seek care right away when the symptoms may be milder. Ignoring an injury may cause it to worsen and potentially lead to the formation of scar tissue in the affected area or bone spurs and secondary problems elsewhere as the body attempts to compensate for mobility impairments. Conditions like chronic back pain can still respond to chiropractic care but keep in mind, it may take longer to achieve a successful outcome.

However, there are times when surgery is necessary. Surgery may include decompression of the nerve without fusion, but in cases of spinal instability, fusion may be needed, which is determined on a case by case basis. There are always risks associated with surgery, which is why it’s so important to exhaust non-surgical options first. When appropriate, your doctor of chiropractic can help facilitate the referral process for a surgical consultation.

If you are dealing with back pain and wondering if you need surgery, you can call Dr. Stephen Heilman at (760) 480 – 4480 and schedule for a FREE consultation to review your case, and a complimentary review of your-x-rays and/or MRI and have a conversation regarding treatment options that may not include surgery. Our office has various treatments available that are designed to relieve pressure on the nerves and discs of the low back region, decrease muscle spasms, decrease inflammation, improve normal flexibility, and re-align the spine to a more normal posture.


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