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Back Pain: The Classic Surgeon’s View

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Handbook of Spine Technology

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Abstract

Low back pain is a major cause of disability worldwide and is a major burden on healthcare systems. Treatment strategies are varied and the role of surgery is under constant scrutiny. Many patients benefit from spinal surgery aimed at relieving back pain, radicular symptoms, and neurogenic claudication.

The initial evaluation of patients with categorization into clinical groups may help in appropriately assigning patients to consideration for surgery. Patients presenting with radicular syndromes (radicular pain, radiculopathy, and neurogenic claudication) are widely regarded as potential surgical candidates. Aside from certain distinct groups, non-specific back pain is, as a rule, not regarded as benefiting greatly from surgery. Specific disease entities (such as central disc prolapse and spondylolysis) might be the exception and should be considered potential surgical candidates.

Patients presenting with radicular syndromes frequently have disc prolapse or spinal stenosis (with or without spondylolisthesis.) After a period of conservative treatment (cognitive behavioral therapy and exercise), surgery may indeed play a major role in treating these patients. Surgical strategies might vary from simple discectomy to complex lumbar decompression and fusions. Outcomes comparable to major joint arthroplasty are sustained for prolonged periods postoperatively.

Careful patient selection and the adoption of less invasive techniques and enhanced recovery after surgery protocols may reduce morbidity and opiate usage in the long run. Surgery remains a valuable and viable option for selected patients presenting with low back pain and associated syndromes.

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Authors and Affiliations

  1. Section of Neurosurgery, University of Manitoba, Winnipeg, MB, Canada

    Neil Berrington

Authors
  1. Neil Berrington
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Correspondence to Neil Berrington .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Allegheny General Hospital Department of Neurosurgery, Mars, PA, USA

    Boyle Cheng

Section Editor information

  1. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Hamilton Hall

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Berrington, N. (2020). Back Pain: The Classic Surgeon’s View. In: Cheng, B. (eds) Handbook of Spine Technology. Springer, Cham. https://doi.org/10.1007/978-3-319-33037-2_131-1

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  • DOI: https://doi.org/10.1007/978-3-319-33037-2_131-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33037-2

  • Online ISBN: 978-3-319-33037-2

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

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