Conservative chiropractic care has become well known for its
ability to help people with low back pain, neck pain, and headaches. However,
some people are suffering debilitating pain and they want an “instant cure”
that will allow them to immediately return to a pain-free lifestyle. This is the
situation where the lure of “minimally invasive” surgical intervention can
become extremely strong. This is understandable because a person suffering
debilitating pain is simply seeking a “cure all” that requires the absolute
least disruption of tissue, pain, disability, and recovery time.
But is minimally invasive spinal surgery truly as good as it
sounds?
Unlike conservative chiropractic care which has a plethora
of scientific studies showing its efficacy in treating a multitude of spinal
pain syndromes, minimally invasive spinal surgery has a sparse and conflicting
track record in the scientific literature. It must be understood that the term
“minimal” is attractive to sufferers of debilitating pain because of the
implied simple nature of the procedures expected to offer relief of symptoms. However, this may not be the case because
there is no definitive definition of minimally invasive spinal surgery. The lack
of terminology definition can lead to ambiguous determination of risks as well
as an over inflation of benefits in the minds of people suffering spinal pain.
It is not that anyone is purposefully trying to obfuscate
the facts regarding minimally invasive spinal surgery but the thought processes
of the average health care consumer wants to believe that the term “minimal”
must mean the procedures are somehow better, safer, or more effective than
previously used protocols. This may not be the case when minimally invasive
spinal surgery is being considered.
In order to be able to discuss the merits of minimally
invasive spinal surgery (or the potential lack thereof) it must first be
defined. Minimally invasive spinal surgery is designed to preserve as much of
the natural spinal structures as possible thereby hoping to avoid excessive
tissue damage, reduce surgical recovery time, and reduce surgical risks. The
use of such techniques has exploded over the last twenty years with the
development of vital technological advances and devices but the fact remains
that there is very little scientific literature delineating the indications for
using these types of techniques and whether they are any better than previously
utilized techniques.
Minimally invasive spinal surgery techniques all share the
common theme of utilizing a small portal of entry into the human body thereby
creating a narrow surgical corridor within which the surgeon can work.
Basically, minimally invasive spinal surgery involves one of three surgical
procedures: ablation, decompression, or fusion-stabilization.
Ablation involves the destruction of nerves carrying pain
signals to the brain or the removal of scar tissue. Common methods of ablation
include using radiofrequency, alcohol, laser, or freezing the suspected
pain-causing tissues located in the spinal disc or facet joint. Decompression techniques, on the other hand,
attempt to relieve suspected pain-causing pressure on sensitive spinal nerves.
Fusion involves the physical fusing of one bone to another in an attempt to
stabilize the suspected pain-causing structures. Regardless of the type of
surgical procedure being used in minimally invasive spinal surgery the question
always arises as to whether the targeted tissue of the surgical procedure is
truly the source of a patient’s pain.
All surgical procedures suffer the same primary challenge of
being able to determine the exact anatomical structure within the spine which
is producing pain. In reality, the inability to exactly pinpoint the pain
producing spinal structures is a major stumbling block in treating these common
maladies, especially in cases of nonspecific back pain. It is this inability to
correctly identify pain producing spinal structures that gives conservative
chiropractic care a distinct advantage as a treatment for spinal pain
syndromes.
Conservative chiropractic care should always be thoroughly
utilized before a spinal surgical procedure of any type is considered. Changes
made to the human body via surgery are irreversible which is why procedures
such as conservative chiropractic care that has been shown to be very effective
for spinal pain syndromes should be utilized before any other techniques
regardless of how “minimal” they are advertised to be.
