When it comes to treating chronic low back pain, there still remains quite a bit of debate and controversy. That’s because it can be very difficult to tell what is the problem and where the pain is coming from.
Even when studying the same problem (e.g., low back pain from disc disease), researchers often come up with conflicting results. For example, some will show conservative care is effective when dealing with degenerative disc disease. Others conclude surgery gives better results.
In order to narrow the playing field, a group of researchers from Chiba University in Japan studied a very select group of patients with painful disc disease. Each one had confirmed disc disease at one lumbar level (either L45 or L5S1). No one had leg pain — just low back pain.
The goal was to get patients with disc degeneration and only disc degeneration and at only one lumbar level. It’s easier to tell if treatment is effective if everyone has the same exact problem.
They found that the patients in the surgical groups had better overall results compared with the exercise group. The results were actually reported as significantly better for surgery.
When comparing the two types of fusion procedures used, the patients who had an anterior (from the front of the spine) approach had significantly better results than those who had a posteriolateral (from the back and side) fusion.
So you can see that the decision is based on multiple factors. Making sure you have a disc problem and not pain from some other soft tissue structure is the first step. Once that has been determined, then the type of surgery to have will be the next question.
With this information, you should be able to go back to your surgeon and discuss the particular specifics about your situation. Ask about the pros and cons of surgery versus continued conservative care as well as the advantages and disadvantages of any proposed procedures. Good luck!