Just cut it out Doc!
This is a model a friend of mine brought over, it shows these small wires running down the spine. The device is called a spinal cord stimulator and it is intended for pain management. When patients have not responded to other treatments or are not appropriate for them this is an option to mask the pain. There are certain populations that this can be a miracle for. There are others that have this thing implanted in their bodies and get no relief. Just like with any surgery, especially spine, there is another group that end up worse off than before. I’ve had multiple patients get them removed because they were causing more issues than they fixed. I know of one that had a complication immediately post-op and can no longer use his legs. (This was due to an infection but the reality is that had his spine not been operated on the infection would have never occured.)
No matter how scary the diagnosis: bulging disc, herniated disc, stenosis, degenerative disc disease, degenerative joint disease, etc. Never forget that these terms mean nothing in the absence of symptoms that directly correlate. Over time our bodies degenerate, it is part of life and all we can do is avoid excessive strains that would speed these processes up. The best way to do this is to stay active and engage in a specific wellness routine that addresses any dysfunctions you may have. The longer you wait the more engrained the compensations become, the harder they are to break.
With the advances in science and technology people have been sold on the idea that if an operation is minimally invasive, it must have minimal risks. What is not understood is that this simply means the operation is performed through the smallest incision possible. This is definitely preferable but by no means should suggest that it is not without serious risk. The space that a surgeon has to operate is extremely limited. There are nerves, blood vessels, and of course your spinal cord. Do not chance your future for a “quick fix”, it does not exist. Even those who end up requiring surgical intervention should be on an extensive program that ensures they understand what factors contributed and how to avoid any recurrence.
I cannot tell you how many patients have gone into an operation expecting to be right back to the same old things they did before. Some are not educated properly, some assume they are healthy enough, and there’s others that just don’t seem care. This is why they say “the best predictor for future spine surgery is prior spine surgery”. A study published in SPINE on November 1, 2020 found that 1/3 of 529 patients followed had poor clinical outcomes following spine surgery. The same study found that patients engaged in regular exercise were at a lower risk of poor outcomes. These findings are pretty consistent across the board when looking at outcomes post operatively.
These operations are intended to be the last resort because even if you have one it is still crucial to learn the mechanics behind why this happened in the first place. Without addressing these issues you are now returning to the same stressors that got you on that operating table in the first place but with restrictions from now having your spine operated on. People often leave the OR and go home to sit in their recliner, some even sleep there thinking they are taking pressure off of their spine. The reality is that this simple act can lead to excessive strain on already weakened structures. Think re-herniation and adjacent segment syndrome. If you are not sure what these terms mean, you should not have an operation until doing more research.
Had these patients seen a qualified provider before surgery they should of been educated on a list of things to avoid and how long these restrictions applied. Postoperatively there is no reason anyone should be sent home without rehab orders. Well I can think of one.. less likely to have that education means more likely to need another operation.. If you feel that you have tried everything you can to avoid surgery and cannot shake the pain please have a conversation with multiple providers before making your decision.
Nerve pain is a different kind of beast and it can easily lead to desperation if it is allowed to progress. Spine issues tend to be recurrent and often progressive. It is very common to have a flare that resolves quickly and doesn’t show back up for some time. Many times, these flares are your body trying to alert you to something minor. When we are unable to recognize the “why” it is difficult to prevent further wear and tear. We assume the issue is gone so we keep pushing and dig ourselves into a deeper hole. Take action early to optimize your performance, avoid excessive strains, and ensure you do not become a statistic of the spine pain industry.
If you need help determinging the best approach to treating your pain please don't hesitate reaching out!