When Did Back Surgery Become an Elective?

Posted on the 25 April 2012 by Georgiaclinic @ChiroAugustaGA

In 2010 researchers reviewed the records of 1,450 patients in the Ohio Bureau of Workers’ Compensation database who had diagnoses of disc degeneration, disc herniation or radiculopathy, a nerve condition that causes tingling and weakness of the limbs.  Half of the patients had surgery to fuse two or more vertebrae in the hopes of resolving their low back pain.  The other half had no surgery.  After two years, only 26% of those who had surgery had returned to work compared to 67% of patients who did not have surgery.  Of the lumbar fusion patients, 36% had complications and 27% required another operation.  According to these findings, if patients overall were better off not having surgery, why would someone choose to undergo back surgery, given an alternative range of other solutions available at their disposal?

Let’s look at the implications of choosing back surgery over any other mode of care, such as chiropractic:

Research suggest that of the 500,000-plus surgeries that are performed annually, as many as 90% are unnessary and ineffective.  Dr. Richard Deyo, MD, a professor at Oregon Health and Science University, notes “It seems implausible that the number of patients with the most complex spinal pathology has increased 15-fold in just six years” and mentions one strong motivation includes “financial incentives involving both surgeons and hospitals.”  A study done by Dr. Deyo in 1994 compared international rates of back surgeries and discovered that the rate of American surgery is unusually excessive and directly attributed to the supply of spine surgeons: “The rate of back surgery in the United States was at least 40% higher than any other country and was more than five times those in England and Scotland.  Back surgery rates increased almost linearly with the per-capita supply of orthopedic and neurosurgeons.”  Dr. Gordon Waddell, MD, director of an orthopedic surgical clinic for over 20 years in Glasgow, Scotland has said that back surgery “has been accused of leaving more tragic human wreakage in this wake than any other operation in history.”  He goes on to say that “Medical care certainly has not solved the everyday symptom of low back pain and even may be reinforcing and exacerbating the problem.”

What is the solution then, when one is plagued by constant back pain that won’t seem to go away?  More conservative, safer and economical options include chiropractic.  Many of our patients at Georgia Clinic of Chiropractic (Augusta, GA) have successfully been able to treat their back pain with chiropractic, when an initial recommendation from an orthopedist was surgery.  Infact, Dr. Pran Manga, PhD, a health economist has said “There is an overwhelming body of evidence indicating that chiropractic management of low back pain is more cost-effective than medical management.”  He is not alone in his assessment.  Numerous international and American studies have shown that for nonspecific back pain, chiropractic is heads above all other treatments.  Dr. Anthony Rosner, PhD, testifying before the Institute of Medicine, stated: “Today, we can argue that chiropractic care, at least for back pain, appears to have vaulted from last to first place as a treatment option.”

The truth is now emerging.  There is broad agreement internationally that surgery should not generally be considered until there has been a trial of conservative nonsurgical care.  According to Dr. Barbara Starfield, MD, MPH, of the John Hopkins School of Hygiene and Public Health, medical care is now the third-leading cause of death in the U.S., causing 225,000 preventable deaths every year as options such as chiropractic are overlooked.  Dr. William Lauerman, MD, chief of spine surgery and professor of orthopedic surgery at Georgetown University Hospital said it best: “I’m an orthopedic spine surgeon, so I treat all sorts of back problems, and I’m a big believer in chiropractic.”


Georgia Clinic of Chiropractic is conveniently located off Furys Ferry Rd in Martinez, Georgia and provides quality chiropractic care to the Augusta, Martinez, and Evans communities. Visit our main website at www.georgia-clinic.com. To schedule an appointment, call (706) 814-5053 or use our online form to schedule online.

The Georgia Clinic of Chiropractic Blog is written by Dr. Mark Huntsman.