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Kestner

During the course of my career in caring for patients in pain, I have seen many patients who have already had multiple spinal surgeries.

I have seen four patients that have had nine spinal surgeries each.  I saw the fourth one recently. After nine surgeries, they are still in pain.

I have never seen any patient with more than nine. It is not uncommon for me to have a patient tell me they have had three or four spine surgeries.

Think about this for a minute. The reason they are in my office is that they are still in pain. The spine surgeries did not stop their pain. In some unusual cases, they have more pain after surgery.

This is important to understand.  I see so many patients that seem to think, “I’ll just get spine surgery and get this fixed and I’ll be all better.” They seem to think it is like having a car part replaced or putting a new roof on a house. “Everything will be fixed then, right?”

It would be nice if this were the case, but it often isn’t.

Spinal surgery can be a very difficult operation and results are simply not guaranteed. Spinal surgeons tend to be very bright, well-trained and have spent years working on procedures to resolve spinal problems with surgery.

The problem is that the spine is very complex to begin with in terms of biomechanics and the delicacy of the nerve structures that are encased within the spine. Add to that the typically degenerated condition of the spinal structures that are affected and other complicating factors and excellent results of spinal surgery become more elusive.

In order to try to address damaged parts of the spine, it is first necessary to cut through healthy tissues to reach them. In many cases, the damage is so severe that the only thing that can take pressure off a delicate spinal nerve is to remove a person’s human bone and replace it with plates, screws and cadaver bone paste in order to fuse the spinal segments.  

From that moment forward, that spinal segment will never move again. It is permanently fused using the hardware and cadaver bone paste which hardens into a concrete-like structure.

Although this often relieves the pain the patient is experiencing for a while, this operation permanently damages the biomechanics of the spine that is supposed to move at each segment. This places the segment above and below the fused joint at risk of needing future surgery.

There are even diagnosis codes that are used in medical evaluation called Failed Back Surgery Syndrome (FBSS). There are now spine surgeon specialists that focus on follow-up surgery after the initial surgery fails that provide what is called Revision Spine Surgery. Revision Spine Surgery is a sub-specialty specifically focused on doing spine surgery that is an attempt to improve on the outcomes of the spine surgery that failed.

All this is not to say the spine surgeries typically fail. Many spine surgeries are successful. But the failure rate is something that should not be ignored by patients. Medical literature estimates the failure rate of lumbar fusions for example to be somewhere between 30 percent to 40 percent.  

You may ask why these patients that have already had spinal surgery are in my office. In most cases their physician has referred them here for our medical acupuncture.  

Fortunately, in some cases we have seen complete resolution of pain in patients that have had several spinal surgeries though our acupuncture. We have seen numerous patients become pain-free for the first time in over a decade as a result of our unique medical acupuncture.

In other cases, the patient has seen significant reduction in pain and improvements in lifestyle that are life changing. They are often able to enjoy activities in life that they had previously given up due to pain.  The patient’s only previous options often included narcotic pain drugs and consideration of more surgery.  

A majority of our post-surgical patients are able to significantly reduce their use of pain medications including narcotics.  In short it is a successful program.

More spinal surgery is usually not a good option at all.  Subsequent spinal surgeries are not as successful as the original surgery as noted in this comment in a medical journal from 2018: “Repeat spinal surgery is a treatment option with diminishing returns. Although more than 50 percent of primary spinal surgeries are successful, no more than 30 percent, 15 percent, and 5 percent of the patients experience a successful outcome after the second, third, and fourth surgeries, respectively.”  — Asian Spine J. 2018 Apr; 12(2): 372–379.

Many patients have found our unique medical acupuncture has brought about significant improvements in their ability to enjoy life without addictive narcotic drugs or risks of surgery. More and more physicians are referring their patients to our office each year.  

Could we have helped these patients before their first or second spinal surgery? Perhaps. It is always better to consider all options before surgery.

Dr. Mark Kestner is a licensed chiropractic physician in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com

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