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The Good, the Bad and the Ugly of Spinal Healthcare

The good, the bad, and the ugly of spinal healthcare is controversial. But here are the facts. One out of five people in any given year will experience back pain so significant they need to change their activities. Half of those people will seek medical care. The cost to manage back pain in the United States is reported at $86 billion, making it the sixth highest contributor to the global burden of disease with low back pain being the number one cause for job disability. 

The good:

  • Most low back pain is acute or short-term and last a few days to a few weeks.
  • Most resolve with self-care and no residual loss of function.
  • The majority of acute low back pain is mechanical.
  • Low back pain is rarely related to serious underlying conditions (i.e. infections, tumors, cauda equina syndrome, abdominal aortic aneurysms and kidney stones)
  • Accurate diagnoses are more common.
  • NIH funded studies and Spine Patient Outcomes Research Trial (SPORT) studies have defined effective treatment.

The bad:

  • 500,000-people every year develop bleeding ulcers from arthritis medicines.
  • U.S.A. makes up 4.6% of world population but consumes 80% of its opiates & 90% of its vicodin.
  • 10 million epidural steroid injections are performed every year in the USA for back pain

The ugly:

  • An average of 37,485 deaths every year from prescription drug overdoses
  • 7,600 deaths per year from arthritis medicines
  • Low back surgery results in a complication rate of 18%

The non-operative and operative treatment of back pain can help relieve most causes. Most back pain resolves on its own within two months so aggressive, invasive procedures are rarely needed. The relief of pain is a noble goal but treatment has risk. Most treatments carry the potential for risks and complications. Better diagnosis, better judgment, better technical skills and conservation of resources hopefully will result in better future outcomes. 

Consider getting a second opinion from a qualified spine specialist as each spine surgeon may hold different opinions based on their training, experiences and values.

To learn more about Dr. Cotler or to schedule an appointment, please call us on (713) 523-8884

Howard B. Cotler, MD, FACS, FAAOS is board certified and recertified in Orthopedic Surgery. He is a fellow of the American Academy of Orthopedic Surgery and the American College of Surgeons.

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