Innovations in Back Pain Surgery: The Promise and the Reality

Surgeons have an arsenal of surgical techniques for low back pain. You've probably heard about traditional surgeries like spinal fusion, which fuses the lower vertebrae together to give the back more stability and dates to the early 20th century. But now there are newer techniques such as using heat to shrink bulging disks and relieve pain (known as IDET, or intradiscal electrothermal therapy) and replacing disks with artificial ones.

Unfortunately the growing menu of surgical options is growing in part because few of the procedures offer a high-percentage cure. Medical companies regularly develop new devices or technologies, but the holy grail of complete relief remains elusive.

"It's a focus of much research and development," says Richard Derby, MD, medical director at Spinal Diagnostics in Daly City, Calif. "We can get a number of patients better or improve their pain, but we don't have the answer yet."

Another obstacle is that, while insurers generally cover well-established spine surgery treatments after scrutinizing the surgeon's diagnosis, getting the authorization for newer treatments, which may be categorized as experimental or investigational by the FDA, can be a challenge.

"The problem is that the insurance companies are rebelling against all of these procedures because many of them are coming out and we haven't proven that they work," says Dr. Derby. "We have a number of studies that have a reasonably good outcome, but when it comes down to the really strict studies, it's much harder."

This is frustrating for both doctors and patients. But as more studies are completed and better versions of the techniques or devices come onto the market, it's reasonable to hope that the picture for people with chronic back pain will improve, even if it doesn't happen overnight.