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Doc recommends spinal fusion from T12 - S1.

Spine Health | Last Active: 1 hour ago | Replies (95)

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@upstatephil

Dear kdks99 - I understand your frustration in trying to find exact, well-researched, complete with statistics spinal research information. I spent countless hours looking for data like that which would tell me what I could expect. Never found it...

The challenge is - as you realize - every person is different, every spine problem is different, every surgeon is different, every medical facility is different, every surgical procedure is different - (I am working to gather a definitive list of spinal surgery options and my partly completed research shows nearly 30 different legitimate spinal surgeries being employed by the medical community).

Simply put: there are too many unique variables to publish any sort of absolute spinal surgery statistics.

In my case, a combination of MRI and X-ray indicated the need for surgery more than 20 years ago. I consulted with an internist, a neurosurgeon, and a close friend who already had spinal surgery. All three said the same thing: Unless you're lying in bed screaming in pain (literally their words) defer spine surgery as long as possible while being mindful that permanent nerve damage can result and should be avoided.

Once I started experiencing obvious symptoms of severe nerve impingement - dead legs in my case - on a daily basis, new MRI/X-ray results indicated that the risk of permanent nerve damage was approaching so surgery became the next best option.

As I mentioned at the top. It's frustrating to make that sort of momentous decision without the hard science data you'd love to have. My suggestion: Be systematic in your consideration of alternatives and view a decision regarding spinal surgery as a personal risk/return analysis.

Are you about to make the decision for surgery? What is being recommended?

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Replies to "Dear kdks99 - I understand your frustration in trying to find exact, well-researched, complete with statistics..."

Thank you for your thoughtful response. I take issue with your premise that because "every spine problem is different, every surgeon is different, every medical facility is different, every surgical procedure is different" it makes it impossible to have reliable statistics regarding spine surgery. Of course, what you stated is true but the same can be said of many other surgical procedures and this veil of confusion seems to exist particularly with lumbar spine interventions. I am not looking for an answer for me in the research....I am wanting to know what evidence exists that a fusion (again statistics are this to be considered when making a decision about treatment) vs. decompression without fusion has a likely better outcome over time in the aggregate.. I think how many people (again in aggregate) have significant pain relief after lumbar spine surgery, etc. how many require subsequent surgeries? When i really pressed my PCP about about many of her patients had adequate relief after lumbar spine surgery she said 50%. Good information although not exactly across population. I did have the MILD procedure (the only research was funded by VERTOS) .The doctor that recommended it said ALL his patients saw improvement because he picked so carefully. He was a at University of Pennsylvania and I had a really good feeling about him. I had no relief and when I wanted a follow up appointment I was told he only had appointments for NEW patients so that might have been why he was so gung ho about this procedure. It would have been nice to have independent research regarding this procedure, as well.
I have consulted numerous physicians, all reputable, all at teaching hospitals and have been told very different things. I liked them and trusted them but how do I choose?

The best across population research I can find is from countries where there is not a profit motive for these very very lucrative procedures. This link is to Swiss research. I think there can be more of this to help us decide. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2794636