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Failed
Back Surgery and Prolotherapy
 Patients often have
chronic low back pain persisting after surgery and are put into the
category of people with "failed back surgery syndrome."
Ross
Hauser, M.D.
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It is easy to find reasons why a back surgery patient would still have
pain after the surgery. During surgery, for example, a discectomy
(removal of the disc), the surgeon must spread some muscles and cut some
of the
ligaments in order to perform the surgery. The surgery itself can
cause ligamentous laxity and instability of the spine.
Another reason for
chronic low back pain after surgery is that another
segment of the spine is now unstable and degenerated. This is very
common after
spinal fusion. The segments above and below the fused area
have to move more to compensate for the fusion. Eventually these areas
become unstable. This applies for the areas above and below a laminectomy and discectomy. With the disc or lamina gone, after surgery
the vertebrae above and below the surgery site must take more of the
load. Eventually these areas become degenerated and unstable and are the
source of
chronic low back pain. In these cases, Prolotherapy to the
correct the instability will help strengthen the segments and relieve
the low back pain.
Most people do not realize how much tissue is removed with surgery. A
laminectomy site heals with scar tissue, not with bone. How strong do
you think scar tissue is compared to bone? This often results in
instability at the level of surgery, therefore leading to an increased
rate of degeneration in this area.
Osteoarthritis will develop faster
when instability is present. This is why the segments above and below
the surgery site are degenerated.
The main point to remember is that surgery involves the removal of bone,
ligaments, and tendons, and Prolotherapy involves the repair and growth
of these structures. The long-term prognosis is much better if
Prolotherapy is performed, in addition to surgery, so instability does
not develop. Surgery of the spine should be considered only after all
conservative treatments have been explored and failed. This includes
Prolotherapy. If Prolotherapy was used as often as it should be, a great
many of the operations done on the lower back would be eliminated.
Another reason pain may not be alleviated with surgery is that the
surgery did not address all of the causes of the back pain. Most
surgeons do not know that the ligaments in the back refer pain down the
leg. Not everyone with
sciatica has a disc problem. This is the number
one reason why back surgery for sciatica does not cure the problem,
because it does not address the
sacroiliac, sacrotuberus, sacrospinus,
or
iliolumbar
ligament
laxity that was causing the pain. Often a
herniated disc and ligament laxity occur together. Dr. R. Barbor (Sclerosant
Therapy. Reunion Sobre Patologia de la Calumna Vertebral. Murcia, Spain,
March 30, 1977) reported that ligament laxity and disc problems occur
together in 80 percent of the cases. In such cases, surgery alone does
not provide complete pain relief. It is relatively common for a patient
to continue to have low back pain after disc surgery. The bulging disc,
in such an instance, was not the only cause of the pain because the area
was not unstable. In this case the person also needed Prolotherapy, in
addition to surgery.
Chronic
Back Pain:
My Opinion: The Best Treatment Prolotherapy
For years, people
have been trying chiropractic
manipulation, exercise,
Steroid injections, and
physical
therapy. All, of course, have their place, but the reality is
that once a person has had pain for six months or greater the likelihood
of their pain being 'cured' is small.
In looking at long term studies it is only Prolotherapy that I have
found that had a significant 'cure' rate. In 1958 Dr. Hackett analyzed
656 chronic pain patients. The average duration of pain prior to prolotherapy
was 4.5 years. The duration of the study was 19 years. It involved
18,000 injections. The cure rate was an amazing 82% with follow up of 12
years!
Dr. Gustav
Hemwall, my mentor reviewed the charts (probably one of his
underlings did) 2007 patients, follow-up was available for 1871 of them,
1399 (75.5%) of them reported a complete recovery and cure!
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