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I wish I had never had back surgery. I was in pain back then and couldn't see my way out of a paper bag. But now I have worse back pain, leg pain, and I'm on my way to a full-blown disability. Why don't they warn us that this could happen?

Most surgeons are aware that there is a 10 per cent reoperation rate for any back surgery. Repeat procedures are common among patients who have had a disc removal for herniation. Estimates are as high as 12 per cent reoperation for this condition. Conservative care is almost always recommended first. A three- to six-month trial of nonsteroidal antiinflammatory drugs (NSAIDs), physical therapy, and activity modification is often recommended before ever considering surgery. But if there is nerve damage that can be permanent or bowel and bladder changes, then immediate surgery is advised. Surgeons and their staff always go over the potential risks with patients regarding any surgical procedure. But if you are in pain at the time this conversation takes place, you may not remember it. Or you may assume those statistics don't apply to you and schedule the surgery anyway. Researchers are trying very hard to figure out who might be at the greatest risk for a poor outcome or recurrence requiring reoperation. Having predictive risk factors of this type could help surgeons guide patients in making the best treatment choice with the fewest risks (including the risk of reoperation).

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