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Back Surgery — Who Needs It?

2007; Massachusetts Medical Society; Volume: 356; Issue: 22 Linguagem: Inglês

10.1056/nejmp078052

1533-4406

Richard A. Deyo,

Anesthesia and Pain Management

Back surgery is not the final common pathway for everyone with persistent back pain. It offers specific therapy for specific anatomical derangements associated with specific complexes of symptoms. When surgery ranges beyond carefully defined situations, we can expect disappointed patients.A generation ago, "back surgery" usually meant removing the offending portion of a herniated disk (Figure 1). Times have changed, and both the indications and the surgical techniques have expanded enormously. Indeed, clinical science has struggled to keep pace with innovation, creating uncertainties about the efficacy and safety of some new surgical techniques. Patients and primary physicians now need a . . .