Surgical Therapy

Abstract

Surgical therapy of the failed back syndrome can be restorative and reconstructive or neuroablative and destructive. Obviously, restorative surgery is inherently more desirable than destructive surgery, but one must keep in mind that ill-advised or ill-performed restorative surgery may yield a destructive result. By definition, all patients with a failed back syndrome have undergone previous back surgery. Nonetheless, to attempt to undertake a restorative operation merely on the assumption that the patient’s previous operation was inadequately or improperly performed is to court disaster. The decision whether or not to recommend surgical therapy for a failed back syndrome sufferer is rarely life or death in the sense of survival, except for the patient who contemplates suicide as an alternative to suffering (see page 140). However, the decision about surgery in these patients is quite frequently of life or death magnitude in a more figurative sense.