Spinal Decompression Or Back Surgery, Which Is A Better Option?

By Dr. Michael Golab with Dr. George Best

Back pain and/or sciatica related to a bulging or degenerated spinal disc often can be difficult to treat, and patients may be left with considering the options of spinal decompression or back surgery. Each treatment option has its pros and cons, but in the end, the best option will depend on a variety of factors that are unique to each case.

There are some misconceptions about both spinal decompression and surgery that can lead to confusion when attempting to determine the best treatment option, especially when pain or medication may be disrupting the ability to think clearly. The following information will help to dispel some of the misconceptions regarding these forms of treatment and will assist pain sufferers in selecting which option is best for their circumstances.

Although spinal decompression is a kind of traction, the effects of spinal decompression vary considerably from those of regular traction. True spinal decompression systems utilize computer controlled motors that can "fool" the muscles along the spine into staying relaxed during the treatment session. This allows for a suction effect inside the spinal disc being treated, which pulls bulging disc material back into the disc and also pulls in fluid and nutrients that help the disc to recover and heal. Since ordinary traction machines must contend with muscular resistance, their effects on the discs are much less and traction typically does not provide long-term improvements in disc health, nor lasting elimination of pain.

While spinal decompression is highly successful in treating most cases of disc-related pain, it is not 100% effective and there are situations in which it is contraindicated. In my San Antonio Spinal Decompression practice, it has been my experience that it is usually not very effective when a patient has a severe disc extrusion, or a full rupture of the disc, rather than just bulging. Spinal decompression is not safe to use when the patient has spinal instability in the are of the damaged disc. In cases where spinal decompression is unlikely to be effective and/or is contraindicated, surgery becomes the only real option for achieving good lasting results.

Surgery is not the ideal solution for disc-related back pain, although it is the only real option in a small number of cases. Although patients sometimes get the idea that surgery will "fix" the problem once and for all, this is often not the case. In fact, one of the leading predictors that someone will eventually need back surgery in the future is having had back surgery in the past. Although aggressive surgical techniques that involve removing a problematic disc will guarantee that a patient will not have any trouble with that particular disc again, these surgeries create other problems that over time can make things even worse than the original problem.

Post-surgical scar tissue and increased wear and tear on adjacent discs can conspire to create new areas of spinal cord and/or spinal nerve compression months or years after spinal surgery. For this reason, it is my opinion that spinal surgery should be reserved as a last resort when all other treatments (including spinal decompression) have failed or have otherwise been ruled out.

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