Recent Research Questions the Effectiveness of Back Surgery


Source: San Francisco Chronicle, Sturgeon Bay, WI (PRWEB) May 29, 2013

An estimated 38 to 50 billion dollars is spent yearly for the surgical treatment of lower back pain in the United States. While this is commonly accepted as the price to pay for this debilitating condition, Chiropractor and Naturopath Dr. J G Moellendorf examines two recent research studies and a neurosurgical university’s health policy questioning surgery’s effectiveness and cost.

Many victims of chronic low back pain turn to surgery when the muscle relaxers, anti-inflammatories, and pain killers fail. Considering the recent research, Sturgeon Bay, Wisconsin Chiropractor and Naturopath Dr. J G Moellendorf, DC, ND, LCP questions whether less costly alternatives to very expensive spinal surgeries might be a better solution.

A research team led by Dr. Benjamin J Keeney looked at workers compensation injuries in the state of Washington to determine if it could predict which work injuries would result in back surgeries. Their results were published in the May 15, 2013 issue of the journal Spine titled Early Predictors of Lumbar Spine Surgery After Occupational Back Injury: Results From a Prospective Study of Workers in Washington State. Out of 1,885 injured workers, 174 (9.2%) had low back surgery within 3 years of injury. The researchers discovered that if an injured worker was first seen by a surgeon, 42.7% would result in surgery, while if first seen by a Chiropractor, only 1.5% had surgery. The rate of an expensive surgery was reduced by 96.5%, just by the choice of the first doctor consulted.

Dr. Anne Froholdt’s research group at the Oslo (Norway) University Hospital followed chronic low back pain patients across a nine year period. Participants were randomly assigned to two groups. The first group had lumbar spinal fusion, while the second received cognitive training on doing daily activities without worrying about further injury, along with endurance and coordination exercises. Publishing their results in the December 2012 issue of the European Spine Journal, they found that during the nine years studied, of those who had spinal surgeries, one-third were operated on again. Of those in the non-surgery group, one-third opted to have surgery done. There were no notable differences in daily rated pain intensity, fear-avoidance beliefs, spinal muscle strength, and use of medication between the two groups. Both groups reported significantly less back and leg pain, less fear-avoidance beliefs, less emotional distress, and improved general function. Sixty-eight percent of those having surgery were out of work, while only forty-two percent of the non-surgery group were not working. Forty-four percent of the lumbar fusion group used medications for pain compared to seventeen percent in those who did not have surgery. Seventeen percent of those having surgery were dissatisfied with their results compared to only three percent among those who did not have surgery.

Dr. J G Moellendorf, DC, ND, LCP asks, “Why would we spend billions of dollars yearly on spinal surgery that has no better results than conservative therapies, while having increased disability rates and higher dissatisfaction with results?”

Realizing the high failure rate and heavy costs of back surgery, the University of Pittsburgh Medical Center (UPMC) health plan analyzed recent research for treating chronic low back pain. On January 1, 2012, UPMC implemented a comprehensive clinical initiative focused on the treatment of chronic low back pain. All lower back surgeries other than surgical emergencies require prior determination for surgical necessity. The policy states:

“To be considered for surgery, patients with chronic low back pain must have:

“This policy was developed using evidence-based literature and professional society guidelines, as well as the input of external medical professionals with expertise in the area”

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