In recent years there have been a spate of articles indicating that spine surgery does not provide the relief that patients seek. Though the proponents of this theory are very much in the minority, they have also been extremely vocal, and their message has gotten outsized attention in the public.
To determine the veracity of their position, a team of researchers from NYU Langone set out to evaluate the impact of spine surgery by comparing its impact to that of adult knee and hip reconstructive surgeries. In examining the outcomes in both single-level spine surgeries and primary hip and knee arthroplasty patients who were treated between December of 2016 and April of 2019, they arrived at two conclusions: That spine surgery patients are suffering from conditions that are far more disabling than those of patients who undergo knee or hip replacements, and that the improvements in pain and function that are derived from spine surgeries are as good or greater than those that follow knee and hip replacement surgeries.
The results of the study were published in the September 15, 2020 issue of the journal Spine. Led by Dr. Aaron J. Buckland, the team noted that there is a public sense that knee and hip replacements are both effective and cost-effective, but that spine surgeries do not generate that same overall positive impression.
They point out, however, that improvements in imaging, diagnostic and instrumentation technologies developed over the last two decades have made a marked difference in patient outcomes that are difficult to score. They chose to use a computer adaptive quality of life metric to compare the outcomes of knee and hip replacement surgeries to spine surgeries including Cervical Disc Replacement, Anterior Cervical Discectomy and Fusion, lumbar laminectomy, and lumbar microdiscectomy and transforaminal lumbar interbody fusion. Patients were surveyed six months after their procedures, when most surgeons agreed that more than 90% of improvements from the procedures would be perceived by patients.
What the researchers found was that when patients were matched for age and gender, the baseline disability for patients who were undergoing spine surgeries was far greater than those of patients undergoing knee and hip replacement surgery. They also found that those who had undergone spine surgeries experienced greater improvement in pain and function that those who had knee or hip replacement surgery. However, the knee and hip replacement surgery patients tended to indicate better function and pain scores after surgery. It was the difference in those scores that had previously garnered such attention, but what the recent study showed was that these scores reflected less overall improvement because their initial condition was not as poor.
Writing on their findings, the researchers concluded, “The results confirmed our clinical suspicions–that spinal pathologies requiring surgery are more disabling conditions than that of hip and knee arthritis. Furthermore, the improvement in pain and function as a result of well indicated spinal surgery was as good, or greater than that of THA or TKA.”
If you have been suffering from spine pain but have been hesitant about considering surgery, we encourage you to contact our spine surgery practice in New Jersey to set up a time for a consultation. Spine surgery can improve your overall function and provide you with significant relief.