When is spinal surgery appropriate?

Very frequently, in fact far too often, spinal surgery is decided as an appropriate course of action with people who have identified issues from imaging after only a short period of pain. The significant body of scientific evidence tells us that:

  • Many ‘problems’ seen on scans are not as well related to someone’s pain as previously thought

  • Many of these issues can resolve if given enough time and the appropriate context

  • Many spinal surgeries have proven in follow up studies to be no more effective than ‘sham’ procedures and have significant risk

  • - Having a spinal surgery profoundly increases the risk of further surgery

  • So when is it ok to have spinal surgery? Well the simple answer is that surgery for back pain should not be considered unless non-surgical options have been exhausted and a period of time of at least 6 months has passed without change in symptoms. Even then spinal surgery has not been proven highly effective in improving pain.

The main indication for spinal surgery is not pain, but risk of harm through evident actual spinal cord injury. This is more than just the loss of sensation but the inability to use a part of the body because of nervous system injury.

So if you’re considering spinal surgery make sure you know the risks, are not just seeking improvement in pain and if pain is a key outcome surgery should be considered a late stage intervention after more reliable and less risky strategies have been tried first.