Tiger Woods is a miracle of modern back surgery.
By which we mean, his kind of outcome is not typical. So, take a moment before you view his epic comeback to win professional golf’s Masters trophy in April as hard evidence that going under the knife is the best option for your back troubles. First, we suggest you read this New York Times article, How Tiger Woods Won the Back Surgery Lottery.
It’s a long read that quotes an impressive roster of surgeons and other medical professionals. Allow us to summarize the key points.
Woods’ situation:
- He had undergone three failed surgeries since 2014 and had turned to opioids despite their inherent risks of harmful side effects and addiction for relief from the pain.
- His last and successful surgery was a complex spinal fusion procedure, in which a disc was removed from his spine and the two adjoining vertebrae are fused together.
- A spinal fusion typically means giving up flexibility for stability in the hopes of pain relief.
- The article quotes spinal surgeon Dr. Sohail K. Mirza who says an outcome like Woods’ from a spinal fusion, where he could come back to reclaim his former competitive glory, is so rare it’s “like winning the lottery.”
The facts about spinal surgery outcomes
- About half of middle-aged people with no back pain have degenerated discs. And at least half of patients in pain who have a fusion for a degenerated disc remain in pain.
- What constitutes back surgery “success?” It’s debatable:
- One study reports a “clinical success rate” of 57 percent after two years. “Clinical success” is defined as at least a 25 percent improvement in overall functioning, with no device failure, no major complications and no neurological deterioration.
- Other medical professionals measure success as more than 30 percent relief of pain and 30 percent improvement in function. On that measure only about half of fusion operations succeed.
Rehab is often as effective, without the risks of an invasive procedure
After almost any kind of back surgery, not just a procedure as drastic as spinal fusion, physiotherapy is still vital to the recovery process. Depending on the nature of a patient’s back problem, non-invasive methods to strengthen surrounding muscles and alleviate the inflammation and stiffness that can aggravate the issue can play a big role to avoid the need for surgery in the first place.
For a pro athlete for whom squeezing out another few seasons can be worth tens of millions of dollars, the risks of spinal fusion surgery may well be worth the risks. But according to the New York Times article, Woods wasn’t even expecting an outcome that would allow him to again compete at a pro level. His chief goal was just to get enough relief to live a normal life again.
A spinal fusion surgery is going to require three to six months of consistent physiotherapy – once the bone has healed enough to allow physiotherapy without risk of injury. The fact that Woods was able to return to his old form is a big testament to the physiotherapy and training regime he undertook after his surgery.
What we think as Chiropractors
In conclusion, back surgery in general does not guarantee a “cure.” The risk of failed surgery, in which the pain persists or even worsens, is substantial. Nor should it be considered reasonable to endure life in pain, dependent on an increasingly risky cocktail of pain medications.
All of which reaffirms what we have said before – invasive (surgical) procedures should be considered the option of last resort. Yes, they are sometimes inevitable. But we urge that all non-invasive avenues to provide relief and restore your quality of life (Chiropractic care, physiotherapy, strength training, postural exercises, etc.) be exhausted first.