Lumbar Spine Surgery: When Conservative Treatments Fail

A persistent ache in the lower back. Shooting pains down the legs. Muscles so tight you can't even stand up straight. For the more than 65 million Americans who suffer from low back pain every year, the symptoms come in different forms, but the problem is frequently the same: a nerve root near the spine is irritated.  

Approximately, 75 to 85 percent of all people will experience some form of back pain during their lifetime. Back pain is the second most frequently reported reason for visiting a doctor, the fifth most frequent cause of hospitalization and the third most frequent reason for surgery.

The good news is that not everyone with back pain requires spine surgery.  Often with the use of conservative treatments, such as, medications, bed rest, heat, message, ultrasonic therapy and physical therapy, back pain in the acute phase can be controlled.  Lifestyle changes, such as, weight loss, exercise, and good body mechanics can result in long term relief.  

If, however, the back pain persists and symptoms begin to radiate into the legs then this may indicate a nerve being irritated or sometimes referred to as “pinched nerve”.  This condition may also be relieved with conservative treatments but if the symptoms persist and are associated with signs such as weakness, walking problems numbness/tingling or difficulty with bladder or bowel function then an evaluation of the spine is required.   

Most often a MRI (magnetic resonance imaging) is required.  Other tests may include a CTS, plain spine X-rays, or electrical studies such as EMG. Once the conservative treatments have been exhausted and tests have been completed, a neurosurgeon can discuss your options.  If the testing does not reveal a surgical cause of your problem then other non-surgical treatments will be offered.   

Pain therapy is now a subspecialty and often Pain clinics offer a full scope of treatments for persistent (non-surgery) pain.  These clinics have experts in biofeedback, steroid injection, and other non-surgical treatments.  Occasional external and/or implantable spinal stimulators are use to override the pain impulses.  And pumps can be implanted to give mini-doses of pain medication to relieve the pain. 

If surgery is required, you will be instructed as to all your options and what the surgery will be.  Today, we have many different surgical options to specifically meet your needs.  The next sections will review these types of operations.

Return to Patient Education


Homepage, Physicians, Specialties, Hospitals, Offices, Insurance, Appointments, E-Mail


Disclaimer:

Every effort has been made by the author (s) to provide accurate, up-to-date information. However, the medical knowledge base is dynamic and errors can occur. By using the information contained herein, the viewer willingly assumes all risks in connection with such use. Neither the author nor UPMC shall be held responsible for errors, omissions in information herein nor liable for any special, consequential, or exemplary damages resulting, in whole or in part, from any viewer(s)' use of or reliance upon, this material.

CLINICAL DISCLAIMER:

Clinical information is provided for educational purposes and not as a medical or professional service. Person(s) who are not medical professionals should have clinical information reviewed and interpreted or applied only by the appropriate health professional(s).

For questions or comments, please contact: bostj@msx.upmc.edu

© 2008 Tri-State Neurosurgical Associates - UPMC

Last Updated: January 1, 2008