New Techniques Minimize Need for Surgery - Part 1

Wednesday, December 31, 1969 | 0

Modern medicine now includes numerous technologies that permit the treatment of low back injuries without surgery, or with minimally invasive surgery. This is an introductory article that will be followed by more detailed articles explaining some of the various new techniques that place emphasis on the pain management physician as the primary treater due to the special techniques necessary for these non-invasive/minimally invasive techniques.

First, lets acknowledge that a very large percentage of back surgeries either don't work, or have undesirable long-term consequences. Some of these issues arise from immobilization of joints which post-surgery place additional pressure on other joints beyond what was intended by the designer of the human body. Other issues arise from re-injury, or from a failed procedure in the first place. In any event surgical solutions involve a large capital expenditure on the part of the health/work comp carrier, large attendant disability (both temporary and permanent) and subsequent return to work issues. Furthermore, the primary driver behind the surgery, pain, reoccurs and/or is not eliminated or significantly reduced.

Different techniques that have been developed over the past few years include: thermo coagulation (IDET), radio frequency ablation, anesthesiology in combination with manipulation, nucleoplasty, and spinal stimulation techniques such as implant therapy or morphine pumps. New surgical techniques, dubbed "Minimally Invasive Spine Surgery" (MISS), also come into play, as well as new iterations of computer controlled spinal stretching or VAX-D.

In coming articles we will explore some of these different techniques and the role a pain management physician plays in containing treatment costs, reducing disability, and returning the injured worker to productivity.

Article by Narayan Rao, MD. Dr. Rao is a Board Certified Anesthesiologist and Pain Management specialist and can be contacted at 310-477-9345.