Back Surgery Can Quickly Relieve Pain

But waiting won't hurt your chances of recovery, new research suggests.

By Serena Gordon
HealthDay Reporter
Wednesday, May 30, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

WEDNESDAY, May 30 (HealthDay News) -- Back surgery can effectively relieve pain for certain back problems faster than nonsurgical means, a new study shows.

On the other hand, waiting to see if the pain goes away on its own won't affect the outcome of surgery if you decide to have an operation later on, a second study found.

Both of the studies, published in the May 31 New England Journal of Medicine, compared surgical treatment of back and leg pain (sciatica) caused by disc herniation or a condition called lumbar degenerative spondylolisthesis, which occurs when one vertebra in the back slips forward onto another.

"Not all pain -- whether back or sciatic -- can be appropriately managed with surgery, but if it is something that can be helped with surgery, like these two conditions, surgery can provide a more prompt relief of pain and return to function," said Dr. Jeffrey Spivak, director of the New York University Hospital for Joint Diseases Spine Center in New York City. He was not involved in the studies.

Another outside expert agreed. Dr. Dante Implicito, chief of spine surgery at Hackensack University Medical Center said that not all people with back pain need surgery. "Many patients are treated conservatively," he said.

An accompanying editorial in the same issue of the journal pointed out that 75 percent of people with sciatica pain see improvement in their symptoms within three months, even without surgery.

However, Implicito pointed out that conservative treatment or a wait-and-see approach isn't always practical. Some people are in so much pain, they can't function or may be in danger of losing their jobs if they can't get back to work, so they opt for surgery sooner rather than later even though they might eventually get better on their own. "These studies show that there can be tremendous improvement if patients are selected well for surgery," he said.

The first study, done in the Netherlands, included 283 people who had severe sciatica -- leg pain caused by a compressed nerve in the spine -- for at least six to 12 weeks prior to the start of the study. Half of the group was selected to undergo early surgery -- an average of 2.2 weeks into the study; while the other half was chosen to receive conservative treatment with the option of surgery at a later date. Thirty-nine percent of the conservative treatment group eventually decided to have surgery, and the average time from the start of the study to the surgery was 18.7 weeks.