Patients must carefully consider the decision to undergo back surgery. The spine is a difficult and delicate place to operate and surgeons are only sometimes able to lessen pain and improve movement, which is why doctors strongly recommend patients seek a second opinion before making a choice. Two patients share their stories about their decision to go under the knife.
A fortunate discovery
Andrea Kramer, from Montgomery Village, Md., opted for surgery after living with nine years of pain from a herniated disk in her lower back. Physical therapy and Lidocaine patches had given her some relief, but finally she begged her doctor to refer her to a surgeon. "I'd always resisted surgery. But the pain was awful. It felt like a knife was being put in my back."
The surgeon gave Kramer low odds on the surgery succeeding. "It was like 85 to 1585 that it would not cure the pain, and 15, or maybe 20, that it would," says Kramer.
There may be a number of reasons why a back operation is not successful. The nerve may not be fully decompressed after surgery, or the surgery itself could cause nerve damage. There can also be scar tissue or permanent loss of flexibility, and degenerative disk pain can always return. In Kramer's case, she suffered from complicating factorsreflex sympathetic dystrophy and fibromyalgiawhich reduced her chances of success further.
Desperate, she went ahead, and it turned out to be a lucky choice: The gel in her disk had calcified, creating a sharp spur that, left in place, might soon have sliced her spinal cord.
"The surgeon said he was going to use a spoon to scoop out the gel and instead he had to go find a pick to actually stab away at the bone. The calcification could have paralyzed me from the waist down, so it was a blessing in disguise to have the surgery," says Kramer.
Though surgery only decreased Kramer's pain by one-tenth, avoiding paralysis was definitive proof that she made the right decision.
Kevin Gulley, 39, from Newton, Mass., wanted to do everything he could to avoid surgery for his repetitive low back pain. For two years, cortisone injections allowed him to exercise and stretch. But, finally, one injection actually contributed to the damage in his back.
"The pressure from the injection caused the disk to rupture further, until pieces of it actually began to break off. I couldn't stand. I couldn't get up to use the bathroom. I had to crawl over the face of the tub to take a shower before I went to the hospital. And then I ended up basically having emergency surgery."
Gulley was eligible for minimally invasive surgery. Entering through a small incision, the surgeons were able to remove only the part of the disk that had ruptured.
Gulley woke from surgery to find that his pain had been dramatically reduced. After four months of rehab he was active again and pain free for the first time in two years. He has maintained a watchful, intense exercise regimen for the past seven years.
"Whenever I have the slightest twinge in my back I get right to the gym and I stretch for half an hour," says Gulley, "because that is not happening to me again."
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