With all the misleading information out there on back problems, even doctors have conflicting views on the best treatments. But it is the decision you make that counts. The problem has always been finding the facts necessary to make a wise choice—or it was, until now. Dr. Edwin Haronian has put together a guide that looks at both the conditions and the procedures, surgical and nonsurgical, and answers common questions about back problems.

Back Surgery begins by examining the anatomy of the back. It then discusses common conditions that result in pain, and the latest and most effective treatments available, from acupuncture to medication to surgery. Included are pre-op and post-op suggestions, as well as a program designed to prevent future back problems. Here are all the facts you need to make the choice that’s best for you.

Edwin Haronian, MD, received his medical degree from Wayne State University School of Medicine, and served his residency at the State of New York Sciences Center in Brooklyn, New York. While there, Dr. Haronian was involved in groundbreaking research that helped introduce new spinal implant techniques. He was later selected as a fellow in spinal surgery at the renowned Kerlan-Jobe Orthopaedic Clinic in Inglewood, California. Today, Dr. Haronian heads one of the fast-growing orthopedic practices in the Los Angeles area.

Contents

Acknowledgments,

Introduction,

Part One

Deciding Whether

Back Surgery Is for You

1. Understanding Your Back,

2. Determining the Cause of

Your Back Problem,

3. Nonsurgical Treatment

Options,

4. Surgical Options,

Part Two

Before and After

Your Back Surgery

5. Preparing for Surgery,

6. Your Successful Recovery,

Part Three

A Healthy Back for Life

7. Preventing Future Back Problems,

8. Psychology and Back Pain,

Conclusion,

Selected References, 

Resource List, 

Index,

Introduction

I wish I could say you are unique, but if you are holding this book, chances are you have joined one of the world’s largest clubs. You have back pain—anything from a slight, nagging ache, to excruciating spasms that affect every aspect of your life. With these symptoms, you have become one of the four in five people who suffer from back pain at some point in their lives, making back-related disorders the most common of any medical ailment. You may possibly become one of the 500,000 people who have back surgery each year, or one of the additional million considering it.

            Whether you are a business executive who first noticed distress while tapping the computer keys at your desk, a contractor who felt the pang while lugging heavy supplies to a job, or a young mother who can no longer lift her precious child, chances are it’s more than just the pain that’s distressing you. It’s the often bewildering array of treatment options. In addition to a number of sophisticated surgeries from which to select, there are many nonsurgical options. As top sources such as The New England Journal of Medicine and the American Medical Association have commented recently, that leaves the confusing decision up to you.

            I am thrilled to offer you a quick, convenient, thorough guide in Back Surgery: Is It Right for You? In my busy practice and at the top spinal research organizations where I have worked, I have seen patients agonizing over their decisions. I know there is a pressing need for comprehensive information about back problems and treatments. The explosion in the technology associated with the treatment of back problems in the last twenty years, and the corresponding growth in the number of available procedures, provide even more good reasons for you to turn to such a guide, since there has also been an explosion of inaccurate and misleading information.

            I was shocked recently when I looked up “disc replacement” on an Internet search engine and saw the dizzying array of information that emerged. Even on sites for which I paid a fee, the material was confusing, and I could not decipher whether something was objective information or a veiled (biased) advertisement. Sites that touted the latest breakthroughs did not have them; the information often lagged behind a few years. But unless you have a medical degree, you probably would have no idea that the information you received was inaccurate, incomplete, or misleading. Back Surgery: Is It Right for You? painlessly cuts through the confusion.

            The first thing you should know about your back is that the spine is the most complicated and delicate part of the body. In order for you to make an informed treatment decision (and prevent future troubles!), it is essential for you to understand your back and what might be causing your problem. That’s why Part One of this book starts by taking a tour of your back to learn about its anatomy, from bones to ligaments to muscles. Equally helpful, I hope, will be the examination of your back’s all-important function as the core of your body, which is crucial to movement and flexibility; as the protector of your nerves; and as the vital highway for information throughout your body.

            Next, you will take a look at what might be causing your pain. There are typical categories into which most spine problems fit. Is your discomfort caused by arthritis, a traumatic injury, infection, everyday stress and strain, or another problem? This book will help you answer that question.

            Nonsurgical options are the first treatments to consider. In recent years, there has been a dramatic increase in the introduction and use of new, effective drugs, including anti-inflammatory medications, pain medications, muscle relaxers, nerve stabilizers, steroids, and patches. In addition to drug therapy, you’ll learn about physical and manipulation therapies, acupuncture, and pain management procedures.

            Then you’ll investigate your surgical choices, including benefits and risks. You’ll take a thorough look at surgeries of the neck, also known as the cervical spine. You may have been presented with the option of cervical fusion, bone grafting, cervical for aminotomy, or cervical disc replacement, and we’ll study each one. Perhaps your pain is in your lower back, in which case you’ll be particularly interested in the discussion of surgeries of the lumbar spine. There are a number of surgeries from which to choose, including lumbar microdiscectomy, lumbar laminectomy, and lumbar fusion, all of which are offered in either traditional or minimally invasive versions.

            If you do decide that back surgery is necessary, Part Two of this book will guide you along the way. First, you’ll learn about preparing for surgery, including choosing your surgeon and care facility, and you’ll find guidelines to help you get ready for either outpatient or inpatient surgery. This book, of course, also offers advice about your successful recovery, exploring what to expect immediately after your surgery, possible early complications, and physical therapy and rehabilitation.

            Equally important is “A Healthy Back for Life,” the last part of the book. In the hope that you can prevent future back problems, this book discusses how to keep your back strong, including safely using exercise to do so. You’ll also learn about nutrition, which is key in the prevention of osteoporosis and in weight management—crucial for a healthy back, since excess weight stresses the back and is responsible for many ailments. And you will examine ergonomics, the study of equipment design that may prevent back problems. Ergonomics has become a buzzword in recent years, but it should be much more than that in your life. I hope that it will become a tool that you can put into practice everywhere—your home, your office, and your car.

            Finally, an entire chapter is dedicated to back pain and personal psychology. For example, depression is a severe but common symptom of back pain, and I will help you understand its challenges. You will gain a better understanding of the pain and pain relief processes in your brain, as well. Knowing how the mind can both react to and resort to physical pain will make the healthful management of your back concerns even more successful.

            I am certainly glad to accompany you on such an important journey. I, of course, can’t single-handedly stop your pain, but I am delighted that Back Surgery: Is It Right for You? May be able to make what is often a highly stressful information-gathering and decision-making process virtually painless.