Believe it or not, one of the most important predictors of back surgery is prior back surgery (Its TRUE). According to the Maine Lumbar Spine Study 1 in 4 patients had a 2nd spine surgery within 10 years. (1) Not only that but the rate of success of surgery vs. conservative care was nearly identical.
Research findings indicate ONLY about 50% of spine surgeries are successful.(2) Basically flip a coin…that is the percent change that any one back surgery will be successful. Just what constitutes success is variable based upon the literature. Some studies base success subjectively on patient report and others base it upon predetermined study metrics of pain and function. Regardless, only a 50% success rate is not overly promising. From there the rates of success drop to less than 30% with any successive procedure. 
Now we can layer in the TRUE #1 predictor for back surgery…ZIP CODE. That’s right…where a person lives makes them more or less likely for back surgery. A large scale review by Dartmouth exposed this secret. (3)
Now when we start to add up these fact, it should make us question the value of spine surgery altogether outside of very extreme cases.
Why then do so many individuals choose to undergo back surgery?
Because the medical community has sold the public that surgery MUST correct pathology if pain is to improve. Society has come to accept surgery as the answer…even though it is at best a 50/50 proposition.
Given 50/50 odds of success and the long-term results of surgery v. conservative care are almost identical – why is conservative care not afforded the opportunity to work toward a solution that does not involve multiple surgeries? The answer no one wants to acknowledge is because society has been told it will not work and surgery is the only option. Thus, only half-hearted attempts at conservative care are done. The mere fact patients are told surgery is only option pre-programs the brain to not recognize the potential for benefit of conservative care.
The SOLUTION:
To properly educate the public on the situation and promote conservative means over, above, and well before any consultation or discussion on surgery.
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