Monday, April 24, 2017

A Quick Note on Back Surgery

I have mentioned before my puzzlement over the issue of surgery for back pain. The statistical studies show that on the whole it does little or no good, but on the other hand I have two friends who swear up and down that back surgery transformed their lives, freeing them from years of pain.

Part of the answer came to me this weekend, through the story of Golden State Warriors coach Steve Kerr. Kerr missed his team's playoff victory Saturday because he was in too much pain to sit on the bench, and he does not know if he will be able to attend any playoff games this year. He also missed about half of last season. He blames his troubles on what the sports press all refer to as his "botched back surgery" of two years ago:
On Sunday, Kerr announced his absence was related to lasting pain from back surgery he had in 2015, shortly after the Warriors' championship win over the Cleveland Cavaliers.

"This past week, for whatever reason, things got worse, my symptoms got worse, and I was not able to coach" said Kerr, who missed the start of the 2015-16 season due to chronic pain as a result of the surgery. "The last few days have been difficult ... I was uncomfortable at practice the other day, and with things getting worse, I just made the decision I couldn't coach." . . .

While Kerr wouldn't specify the recent afflictions, saying only that he felt "discomfort and pain," he did say that he would tell anyone suffering from back pain not to get back surgery.
So I suppose the reason the overall numbers are a wash, despite the many success stories, is that for some people back surgery is a disaster. Surgery is always dangerous, and more and more studies have lately shown that the harm done by some kinds of surgery (heart bypass for angina, arthroscopic knee surgery for torn cartilage) balances out the benefit. So I'm with Kerr: if you can get by without it, don't let them cut you open.


G. Verloren said...

You said it yourself, but it absolutely cannot be repeated often enough.

Surgery is dangerous. Surgery is dangerous. Surgery is really, seriously dangerous.

Yes, even "minor" surgeries, as it can easily be argued there's actually no such thing, because no surgery is ever truly minor.

The only time you want to undergo surgery is when it's overwhelmingly necessary - you've already been in a major accident or been seriously wounded, or you've got some other complication that will endanger your life (or at least destroy your quality of life) if left alone.

The average person is too casual about the notion of surgery. We simply don't give it the respect and caution it deserves.

Shadow said...

I chose 30 years ago not to have back surgery and don't regret it. Most of the time there is no pain, only a felling of weakness in my lower back. Bending over or twisting my torso is always a crap shoot, and I have been bedridden more than once. Still, I know more people who regret the surgery than don't, and all have more pain than I do and no more mobility than I have. And since I made that decision all those years ago both my father and brother have had surgery (not back surgery), and both have had problems recovering from anesthesia. My testimonial.

G. Verloren said...

@Shadow Flutter

Interesting that you should mention anesthesia.

As I understand it, we don't actually scientifically know how or why anesthesia works. We know that certain substances are effective anesthetics - but only because of lots of trial and error over time. We don't really understand the biological operations involved, in large part because the human brain and nervous systems are still such large mysteries themselves.

There was a case not that long ago of an individual in a several year coma who the doctors noticed was sleeping poorly (unconsciousness and sleep are different things, weirdly), so they administered insomnia medication with the intent of easing their sleep cycle, and were surprised when it caused them to emerge from the coma. Further testing revealed that for at least certain kinds of vegatative states, these drugs produce similar effects in other individuals - at least, sometimes.

This pretty much the way we've learned most of what we know about anesthesia - accidents and serendipity, revealing trends that mostly hold true, but not always. Heck, it all started with a guy just messing around with nitrous oxide because it made him laugh and experience euphoric effects when he breathed it in. And this is a chemical whose other primary uses today are in rocket motors and internal combustion engines!

Michael said...

I had a severely herniated disc repaired 24 years ago when I was 35. For several years lower back pain had come and gone, but by late 1992 there was numbness in my leg and toes indicating nerve involvement. The thing went "bad" in early January, and the pain was blinding. I lived in a codeine cloud for 6 days, then had the 2 hour surgery. The incision was 1.5 inches long and closed with two heavy duty Steri Strips (big band aids). I have been 110% "healed" since. When, after 30 days, the surgeon released me, I asked why it was so easy. He said, "You're not overweight and you exercise regularly." I know other have different experiences, but mine was a stellar success.