The Secret Behind Low Back Surgery Research

Tuesday, March 29th, 2016
Doctor Performing Surgery

We see patients almost daily that have been considering, or are considering, spinal surgery as a solution to their pain. Far too often, they see surgery as an early option rather than the last option. We are careful to advise our patients that there are only a few reasons to consider low back surgery initially.

There are certainly urgencies that require immediate surgical treatment. Things like myelopathy and atrophy require immediate attention. In general, however, outside of conditions requiring immediate attention, surgery should always be the ultimate and final option.

This is not only because it is invasive and has serious risks and a significant recovery period, but also because many surgeries must be repeated. Even in successful outcomes, the patient is likely to develop spinal conditions above and below the site of surgery as the years pass by. Of course there are lost causes and cases that are beyond helping conservatively, but we simply believe there are better ways to go about treating spinal pain than surgery in general.

The research abstract we highlight here has to do with research on the lower back surgery. It’s rather eye-opening.

Why they did it

Since low back pain is so predominant with medical appointments, and related surgeries remain controversial, as well as the fact that new techniques for surgery and treatment continue to emerge, the authors felt it important that low back pain treatment be evidence-based through solid research. They basically wanted to gather up all of the research they could find on low back surgery in order to analyze the outcomes, the quality of the research, and the conclusions of the research papers.

How they did it

  • The authors used available medical databases to search for any research having to do with low back pain and surgical treatment.
  • There were two different independent investigators.
  • The quality of each research paper was assessed through professional, standardized questionnaires (AMSTAR and PRISMA).
  • It was determined that none of the authors of this paper had any conflict of interest.
  • The diagnoses in the paper were categorized separately as disc herniation, spondylolisthesis, stenosis, facet joint syndrome, and degenerative disc disease.

What they found

  • The authors included 40 reviews in this study.
  • According to the quality questionnaires, only 5%7.5% of the papers were rated as excellent.
  • Most of the research papers were rated as being of fair.
  • In addition, 22.5% of the reviews (AMSTAR) we’re determined to be of very poor quality while the other questionnaire (PRISMA) determined that 7.5% of the papers were of very poor quality.
  • Ultimately, only 44% of the papers had a conclusion that was evidence-based and 37.5% didn’t even reach a conclusion to the primary objective.

Wrap it up

Most systematic review papers on lower back pain and surgery don’t reach very good or excellent quality. In fact, a mere 27.5% of them even contain evidence-based conclusions.

That simply does not bode well for those considering lower back surgery at this time.

However, there is an abundance of solid research showing the effectiveness of spinal mobilization, Manual therapy, and rehabilitative exercise for the treatment of low back pain. Safely, conservatively, and non-invasive.

Martins DE, et. al., “Quality assessment of systematic reviews for surgical treatment of low back pain: an overview.” Spine J. 2016 Jan 27.

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
Creek Stone Integrated Care