Commercial Drive - East Vancouver Chiropractor; Dr. Dominic Chan DC - "Chronic Back Pain Sufferers; Beware of Surgery!"

Many sufferers of severe low back pain, especially if it is chronic in nature, have weighed the option of surgery to treat their condition. However, this study is another example of why it is prudent to consider other, more conservative options like Chiropractic more seriously. The study in question focuses on the long term outcomes of patients who have undergone spinal surgery and how it has affected their work specifically. 

The conclusion in general is that spinal fusion surgery, an increasingly controversial procedure that has exploded in the last 20 years, leads to HIGHER rates of permanent disability in workers. This is in comparison to those who were treated more conservatively and without the use of surgery.

The researchers in the study randomly selected 725 patients who underwent spinal fusion surgery to treat their chronic low back pain, compared to 725 patients who opted for more conservative treatments. All the patients were chosen from a pool of worker's compensation claims from the American state of Ohio and all patients suffered from chronic low back pain. The selected cases came from the years 1999 to 2001 and further analysis was done 5 years later in 2006 to see how the patients recovered.

The results will definitely surprise you! When the study ended in 2006, nearly all outcome categories were WORSE in the surgical group. Only about a quarter had returned to work after two years, compared with two-thirds of non-surgical patients. About 11% were considered to be permanently disabled compared to only 2% of those who did not undergo surgery. However, another sobering finding was that the use of prescription pain killers at least 5 years later was at about 85% for those in the surgery group! This compared to 49% in the non-surgical group. As an aside,  the researchers also noted that the patients in the surgery group steadily increased their usage of prescription pain killers over the years.


But unfortunately that's not all,  36 percent of the spinal fusion group had complications from the surgery, including meningitis, kidney failure and death. The re-operation rate was also 27 percent in the surgery group, and included three people who underwent four re-operations. And total days off work was also greater in the spinal fusion group (1140 days vs. 316 days).

 "I'm not saying don't have lumbar fusion surgery . . . but it should be carefully evaluated before it's done," said lead study author Dr. Trang H. Nguyen, who practices occupational medicine in Cincinnati and conducted the research while a doctoral candidate at the University of Cincinnati College of Medicine. "The chances are it will have a poor outcome." However, to be fair surgery may be the best option for certain patients, including those who suffer from an unstable spine or who have suffered severe fractures. The problem is that these patients are a very small percentage of patients who suffer from chronic back pain. 

The perplexing side to this story is that these results and results from similar studies have cast doubt on the rationale of surgery for chronic back pain for years now but the rate of surgeries continues to grow exponentially. In spite of continued improvements in surgical equipment and procedures, it seems the long term results for surgery patients is still astonishingly poor.

Now from my own clinical experience I have seen dozens of patients who have seen me because their family doctor or even specialist recommended surgery to treat their back pain. These patients arrive to me looking for another solution that doesn't require surgery and frankly, often see me as a last resort. This is when I get really honest with the patient. First off I inform them that yes, Chiropractic is a conservative form of therapy that has been successful for other people with the same problem. After a thorough history and exam, I often propose a 'trial' run of several sessions to see how the patients respond to care. If they respond well and get relief then everyone is happy and a surgery could be avoided. But, I also inform my patients that they will have to put in significant effort to get better as well, complying with prescribed home stretches and exercises that will help their recovery. 

Now what's my opinion on surgery? I think for some patients, it's the way to go. In my years of practice I can say I have told three patients that, "yes, I honestly think surgery is your best option". But for the vast majority, they respond very well to Chiropractic and are very happy with the results. Most importantly, they just avoided a major surgery and everyone wins!

If you have any questions about this post or questions in general, leave them down below. Even better, if you're in the Commercial Drive neighborhood of East Vancouver, come by and visit or check out the website;COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC!!!

SOURCES: Trang H. Nguyen, M.D., Ph.D., occupational medicine specialist, Cincinnati, Ohio; E. Kano Mayer, M.D., staff physician and physiatrist, Cleveland Clinic for Spine Health; Leah Y. Carreon, M.D., clinical research director, Norton Leatherman Spine Center, Louisville, Ky.; Feb. 15, 2011, Spine.