Research: Surgery For Low Back Pain Review of Evidence

Wednesday, July 16th, 2014

Why Did They Do It?
The researchers wanted to update their understanding of the benefits as well as the harmful effects of surgery in the cases of non-radiating (no pain into the leg) back pain as well as surgery in patients with common degeneration, radiating pain (pain into the leg) due to a herniated disc, as well as surgery for pain that was due to stenosis of the spine. Spinal surgery is very common these days but it’s still unclear as far as when, where, and why it’s being done.

How They Did It

The researchers used databases called Ovid MEDLINE and Chochrane to search the research abstracts having to do with their study. They took randomized controlled trials and reviews.
They used 2 independent reviewers.
They followed specific rules and guidelines in their review of the literature.

What They Found

In Non-Radicular low back pain with degeneration, there was fair evidence showing vertebrae fusion to be no better than intensive rehab but slightly to moderately better than standard nonsurgical therapy without intense rehab.

In Radiating pain from a herniated disc, there was good evidence that discectomy (surgery) was moderately better than nonsurgical treatment through 2-3 months after the operation. I think it’s important to note that it is not clear, in fact it’s doubtful, as to whether the researchers considered or compared conservative spinal decompression recovery and success rates to those of surgery so….let’s keep that in mind before accept that the surgery was “moderately better than nonsurgical treatment.” In our experience here in my office, that would only be true in a handful of cases out of several hundred. They’re just not looking at ALL of the information in this case.

They also found that benefits with surgery often decreased over the long-term when followed up on.

What Was Concluded?

Surgery for radiating pain from a herniated disc and/or spinal stenosis that is actively hurting is associated with short-term benefits when compared to nonsurgical therapy. Although, as noted above, they aren’t including ALL nonsurgical therapies when making this opinion. They did not consider spinal decompression, cold laser, spinal manipulation. 

For non radiating back pain in the case of degeneration, fusion surgery is no more effective than intensive rehab.

Study was done by:
Chou R, et al. 
JournalSpine (Phila Pa 1976). 2009 May 1;34(10):1094-109. 

Just another reason to call a chiropractor TODAY!

Research and clinical experience shows that, in about 80%-90% of headaches, neck, and back pain, in comparison to the traditional medical model, patients get good or excellent results with Chiropractic . Chiropractic care is safe, more cost-effective, it decreases your chances of having surgery, and it reduces your chances of becoming disabled.  We do this conservatively and non-surgically. In addition, we can do it with minimal time requirements and minimal hassle on the part of the patient. And, if the patient develops a “preventative” mindset going forward from initial recovery, we can likely keep it that way while raising your general, overall level of health!  

Please feel free to leave a comment and tell me your thoughts. I’d love to hear what you think.

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Till next time……

The Amarillo Chiropractor Blog is written by Dr. Jeff Williams.

Amarillo TX Amarillo Pain & Accident Chiropractic Clinic provides customized chiropractic care to the Amarillo, Canyon, Pampa, Happy, White Deer, Dumas, Groom, Conway, Panhandle, Claude, Clarendon, Borger, Tulia, Hereford, Fritch, Bushland, and Vega communities. Visit our main website at for customized Chiropractic in Amarillo TX.

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by Jeff S. Williams, D.C.
Chiropractor in Amarillo
Accident Chiropractic