The Hidden Risks of Spine Surgery: A Patient’s Journey and a Call for Conservative Care

 The Hidden Risks of Spine Surgery: A Patient’s Journey and a Call for Conservative Care


Spine surgery is often seen as a definitive solution for conditions like cervical PIVD (Prolapsed Intervertebral Disc), but the long-term consequences can sometimes outweigh the benefits. A recent case I encountered highlights why we must rethink our approach to spine care and prioritize conservative treatments whenever possible.


A Patient’s Journey: From One Surgery to Another


A patient underwent an anterior cervical discectomy and fusion (ACDF) 3–4 years ago. At the time, surgery seemed necessary to relieve their symptoms. However, their latest MRI revealed a troubling development—a new PIVD had formed at C5-C6, just above the fused segment.


Why Did This Happen?


Spinal fusion alters natural spine mechanics, reducing movement at the operated level but increasing stress on adjacent segments. Over time, this excessive strain can cause adjacent segment degeneration (ASD)—a well-documented consequence of spinal fusion (Hilibrand & Robbins, 2004). In this patient’s case, the fusion led to new disc degeneration and symptoms severe enough to warrant another surgery.


The Reality of Repeat Surgeries


This patient’s story is not unique. Studies indicate that a significant number of patients who undergo spinal fusion develop ASD, leading to the need for further surgical interventions. But each additional surgery brings:


✅ Higher risk of complications

✅ Longer recovery times

✅ Greater financial burden

✅ Increased chance of chronic pain and stiffness


Can Surgery Be Avoided?


The good news is that research suggests 70–80% of spine surgeries might be avoidable with non-surgical approaches like:


✔️ Physiotherapy – Targeted exercises to restore mobility and strength

✔️ Chiropractic & Manual Therapy – Gentle spinal adjustments and mobilization

✔️ Rest & Lifestyle Modifications – Avoiding activities that worsen symptoms

✔️ Medications & Injections – Managing pain and inflammation effectively


Surgery should be reserved for cases where there is progressive weakness, loss of bladder/bowel control, or failure of conservative treatment over time (OrthoInfo AAOS, 2023).


A Call for Smarter Spine Care


As healthcare providers, we must educate patients about all available options and emphasize long-term spinal health. While surgery has its place, it should not be the default solution. Instead, let’s prioritize patient-centered, conservative care that minimizes long-term complications and enhances quality of life.


What are your thoughts on balancing surgical and nonsurgical options for spine conditions? Let’s discuss in the comments!




References

• Hilibrand AS, Robbins M. Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion. Spine J. 2004;4(6 Suppl):190S-194S.

• Cervical radiculopathies: conservative approaches to management. PubMed ID: 12380550.


Dr. Umarfarooque Khan

📧 physio.farooque@gmail.com


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