FOR LOWERBACK PAIN, SPINAL FU­SION IS BEST

Men's Health (Singapore) - - HEALTH -

The Ori­gin

The ver­te­brae lin­ing your back­bone are cush­ioned by shock-ab­sorb­ing discs. Over time, disc dam­age leads to mi­cro­move­ments that can trig­ger pain. On an X-ray, CT scan, or MRI, the narrowing of space be­tween ver­te­brae is of­ten in­ter­preted as disc de­gen­er­a­tion and the source of pain. It would seem log­i­cal, then, that fus­ing ver­te­brae and/ or re­mov­ing bone would limit mi­cro­move­ments, make space for nerves, and ease the ache. This thinking led to a 70 per­cent spike in such surg­eries from 2001 to 2011. About 400,000 are done an­nu­ally.

The Truth

A re­cent study de­ter­mined that up to 40 per­cent of peo­ple who un­dergo back surgery could con­tinue to have sig­nif­i­cant pain af­ter­ward. Rates of com­pli­ca­tion from such op­er­a­tions can be up­wards of 20 per­cent. Even with to­day’s med­i­cal ad­vances, find­ing the cause of lower-back pain is very dif­fi­cult. About 85 per­cent is the “non­spe­cific” type and surgery is typ­i­cally not the best op­tion. In 2017, the Amer­i­can Col­lege of Physi­cians pub­lished new guide­lines, rec­om­mend­ing non­phar­ma­co­logic, non-sur­gi­cal op­tions, such as ex­er­cise and cog­ni­tive be­havioural ther­apy, to treat acute and chronic lowerback pain.

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