Surgery for Lumbar Degenerative Disc? How About Doing it a 2nd Time?



The decision to undergo any type of spinal surgery is a difficult one for everyone.  But what if you had to consider not one, but a SECOND surgery as well?

Turns out, there is a large chance this may be the case.  (Spoiler alert: I’m a chiropractor whose main goal is to keep patients out of surgery)

First of all, the realities.  If I had a dollar for every time someone told me he or she had lumbar degenerative disc problems and was going to avoid surgery at all costs, I’d be doing this post from my own island in the Caribbean.

Most of those who informed me of this goal have that tone of inevitability to the voice.  Like there is no other option except to delay the surgery.  This could not be further from the truth.  I just had a conversation yesterday with a young doctor who informed me that he had L5-S1 disc degeneration and would love to be more active in the martial arts to try to stabilize his spine and avoid surgery, but every time he tried to train, it flared up his low back.

This doctor had not tried seeing a chiropractor competent in advanced soft tissue techniques that has a high likelihood of giving him almost complete relief.  So of course I gave him some resources to find a doctor who might be able to help.  There is no guarantee that this would help, but it would be foolhardy to even consider surgery without trying.

But what about all those other patients who incorrectly think there are no other options?  The ones who stress about whether or not to have surgery on his or her low back?  This decision alone is challenging.

But what if the risks of having to have a second surgery were high enough so that this same contemplative patient really needs to be deciding if he or she can undergo TWO surgeries, not just one?

You know I wouldn’t be asking this question if it didn’t have anything to do with this particular study.

In it, researchers looked at the risk of having a second surgery when the first one was done for stable (without a spondylolistethesis) lumbar disc degeneration over the next five years.  Here’s what they found:

  1. The resurgery rate was 4.7% at 3 months,
  2. 7.2% at 1 year,
  3. 9.4% at 2 years,
  4. 11.2% at 3 years,
  5. 12.5% at 4 years,
  6. 14.2% at 5 years.
  7. Based on this trajectory, they calculated a reoperation rate of 22.9% at 10 years.
  8. Reoperation rate was not different between decompression and fusion surgeries.

Wow.  Over a 1 in 5 chance you’re going to have to go under the knife a second time, with all the additional costs, downtime and rehab.  Worse—outcomes after a second surgery are worse than after the first surgery.

Not a rosy picture.  But heck—don’t see a chiropractor—we’re all quacks and dangerous to boot.

 

James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.







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Categories: Chiropractic Care, Low Back Pain, Osteoarthritis
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