As a physician I have seen thousands of patients with lower back pain some of who go on to have back surgery. Surgical therapies for back pain include discectomy, foraminotomy and fusion. A discectomy is where a portion of the protruding disc is trimmed thereby relieving its compressive effect on the nerve root.
A foraminotomy is opening the doorway (neural foramen) through which a nerve passes as it leaves the spine. Its goal is to relieve the compression on the nerve root.
A lumbar fusion removes the lumbar disc and replaces it with an artificial disc, spacer or bone along with stabilizing hardware. The theory is that the disc is the pain “generator”.
Unfortunately with all back surgeries patients are exposed to the risks of surgery, anesthesia and extensive rehabilitation. Another issue that is rarely addressed is failure. That is to say that the surgery may not relieve the pain and can in some cases makes it worse. Surgery is a one way door. Once the disc is trimmed or removed there is no turning back. One year and 4 year studies have demonstrated no difference between surgery and conservative therapy in patients with low back pain.
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