Back Surgery Alternatives
How is Lordex different than surgery?
Why not consider surgery first?
If I am considering surgery, what questions should I ask the surgeon?
What are the surgial risks of lumbar spine surgery?
How is Lordex different than surgery?
A spine surgeon may do one of two things, decompression laminectomy or fusion to stabilize. These procedures require cutting of the tissue, weakening the support tissue, and exposing the patient to the risk of anesthesia. In addition to the high cost, historically both procedures have only a 50/50 chance of long-term relief.
Lordex provides successful long-term relief from back pain, but from the standpoint of a non-operative closed procedure. Surgery is open reduction decompression. Lordex is closed reduction decompression. Surgery is open fusion for stabilization. Lordex is closed stabilization through increased Para spinal muscle strengthening.
There are three phases of the Lordex Procedure.
Phase 1 is Relief.
As a general rule, most patients experience significant changes in symptoms within the first three to eight Lordex procedures. Occasionally, a more advanced degenerative condition or multiple level herniated discs may take 10-15 sessions before realizing a major decline in symptoms. Also, some patients appear to have rapid relief after the first treatment. Relief response varies according to age, body morphology and degree of severity.
Phase 2 is Correction.
As strength is regained in the lumbar spine, circulation is restored to the damaged disc, and the healing begins. Correction implies that the progressive process that leads to the painful episode has been slowed, stopped or reversed. This corrective process occurs simultaneously with symptom relief.
Phase 3 is Strengthening.
The process that leads to most low back pain (mechanical spinal pathology) involves destabilization of the support structures, degeneration and abnormal adaptation. The Lordex procedure quickly reintroduces kinetic activity to the joints, muscles, tendons and ligaments to help you regain back strength and restore lost lumbar stability.
Each patient will complete 20 – 30 Lordex procedures at various paces. Some prescriptions will be daily for 20 – 30 treatments; others may be daily for 1-2 weeks followed by a decreasing frequency. At the Center for Low Back Pain, your condition sets the standard for your care.
Following completion of the Lordex Protocol, you will be prescribed a Lordex Spinal Hygiene Machine. This home unit has been specially designed to help each patient maintain the same level of improvement acquired during in-office Lordex therapy. An easy-to-follow video to help you continue your home therapy accompanies the unit.
Why not consider surgery first?
The Center for Low Back Pain has treated many patients who were told that surgery was their only option for relief. Our outcomes have shown quite the opposite. Our patients have averted the need for surgery and improved to a satisfactory level as rated by them. The Center has a very high success rate, and in those cases where patients do not succeed with us, the patients are better surgical candidates. By working through the comprehensive layer of our protocols, the Center further weeds out those patients who can avert surgery.
The Center for Low Back Pain is not opposed to drugs, surgery or anything else that will help to lessen the suffering of a patient. The Center works closely with surgeons, anesthesiologists, primary doctors and all other health care practitioners to ensure that all options are exercised prior to engaging surgery.
The Center, on behalf of its patients, takes issue with the appropriateness and timing of many surgical procedures on the low spine. Unfortunately there is no unified agreement as to what constitutes a surgical patient. However we feel there are two cases in which surgery is needed quickly: 1) if the patient has completely lost bowel or bladder control, 2) or complete loss of motor function and ability. We use the word complete in its fullest sense, not just a weakness of muscle or urgency of bladder or bowel function. All other scenarios are candidates for the protocols we use at the Center.
There is no evidence in the medical literature to support surgery as the correct answer for lower spine problems as a primary response except in the cases previously stated. All other options that seem reasonable, that have a track record of success and that will not harm the patient must be exhausted prior to visiting the surgeon.
The first axiom for anyone in the healing arts is to “ first do no harm”. Pain is NOT a reason to entertain surgery and it is most often when the decision to do so occurs. It is the specter of hope that the surgery will bring the requisite relief that drives the patient into the surgeon’s hands. This is completely understandable and human to do so. It is incumbent upon the practitioner offering surgery to resist the temptation and avail themselves of the other alternatives.If there exists a void of knowledge about what can be done or if there is a bias towards a therapy or type of practitioner then it must be challenged. Narrow mindedness is the most dangerous thing to your health. Here at the Center we stand ready to talk with and educate other health practitioners.
If I am considering surgery, what questions should I ask the surgeon?
If you are considering surgery as a solution to your low back pain you should ask the surgeon the following questions:
1. Will the surgery result in permanent relief of my symptoms? If not how long might I expect to have significant relief? Will there be residual symptoms or a possible worsening of symptoms? What outcome can you guarantee?
2. Can scar tissue from the procedure cause the problem to return or be worse than before? If not, how do you know?
3.Will the procedure cause my spine to be unstable mechanically?
4. Will the procedure cause the spinal level above and/or below to be at greater risk to herniate in the future.
5.How often do your patients return for repeat procedures to the same or additional levels?
What are the surgical risks of lumbar spine surgery?
If you are considering surgery you should have the following facts at hand:
Surgery is usually the last resort and the most problematic of the treatment alternatives. Its failure rate is extremely high (over 50%) and its inherent risks are extremely serious.
First, while low back surgery focuses on complete removal of bone, disc and other supportive soft tissue structures, the anatomical location of the disc makes its complete removal impossible. Because of this fact, the remaining portion of the disc can continue to place pressure on the afflicted nerves and thereby cause continued pain.
Second, because these structures are physically close to one another, and because surgery in the lower spine is in itself stressful to the area, even structures that have not been removed can become damaged or stressed as a result of the surgery and themselves become a new source for pain.
Third, surgery always results in the formation of some amount of scar tissue. If the scar tissue itself forms near any of the nerves, it too becomes an independent source for pressure and consequently for pain.
Fourth, since disc removal surgery inevitably takes place right near the afflicted nerves, there is a distinct possibility that the nerves themselves will be damaged during the procedure. If that happens, the nerve damage itself results in continued pain.
Fifth, low back surgery always requires the use of anesthesia and anesthesia itself is associated with a great number of medical risks including death.
Sixth, all surgery, including low back surgery, is associated with infection risks. The risks begin preoperatively with the injection of anesthetics or other preparatory drugs and continue straight through the surgical procedure itself. The risk of infection remains throughout the postoperative recovery period whether that recovery occurs in hospital or out. If infection sets in, the infection itself can cause independent medical problems as well as become an independent source of pain.
Seventh, low back surgery requires significant recovery time…. time which many patients can ill afford to lose.
Eighth, many low back pain sufferers are not good candidates for surgery either because they have medical conditions that raise the normal risks to intolerable levels, or because their particular sources of low back pain are not susceptible to relief via surgery.
Finally, even if the surgery is successful in and of itself, and even if no procedure-related problem actually develops; there is always the distinct possibility that at some future time, the sheer force of normal weight and gravity on the spine during the course of everyday life will result in development of new sources of pain. If that happens, the patient is back to square one.
