Steve Kerr, current head coach of the Golden State Warriors is recovering from back surgery. As with any major surgery, Steve Kerr is currently dealing with a complicated and lengthy recovery process. On a recent interview, Kerr stated that anyone with a back problem should exhaust every available option before undergoing surgery.
It's no secret that back problems are a major pain to the American public.
Americans spend nearly $86 billion a year on their aching backs, which is just about on par with the outlay for cancer treatment. Of the 56 million Americans who have back pain, only 5% need surgery. At some point in their lifetime 8-10 Americans will suffer from some sort of acute or chronic back condition. In the U.S., more than 1,150,000 people go under the knife for spinal problems every year, a rate double that of most developed countries. After one surgery, you may not be done. By two years after the initial surgery, about 8% of patients have had another operation; by 10 years after, the rate jumps to 20% according to a recent analysis Washington State hospital data (1).
Diagnosis and management of recurrent disc herniation were associated with an average cost of $26,593 per patient, and the average cost was markedly less for patients responding to conservative treatment, $2,315. Those requiring requiring revision surgery racked up an average bill of $39,836 (2).
Just 26% of Ohio Workers Returned to Work after Back Surgery with Increased Opioid Use
Researchers reviewed records from 1,450 patients in the Ohio Bureau of Workers’ Compensation database who had diagnoses of disc degeneration, disc herniation or radiculopathy, a nerve condition that causes tingling and weakness of the limbs. Half of the patients had surgery to fuse two or more vertebrae in hopes of curing low back pain. The other half had no surgery, even though they had comparable diagnoses. "After two years, just 26% of those who had surgery returned to work. That’s compared to 67% of patients who didn’t have surgery. In what might be the most troubling study finding, researchers determined that there was a 41% increase in the use of painkillers, specifically opiates, in those who had surgery (3)."
Mark Russi from the Yale University School of Medicine, notes "The outcomes among those undergoing fusion were alarming. On a practical clinical level, the study suggests that patients contemplating lumbar fusion surgery need to be educated regarding the sub-optimal outcomes associated with the procedure. Patients contemplating lumbar fusion surgery should be informed regarding the outcomes associated with the procedure, including the low likelihood of returning to work, high rate of reoperation, high rate of complications and the possibility of permanent disability."
A study of 1885 Washington workers showed that early predictors of lumbar spine surgery within 3 years of low back injuries. "Reduced odds of surgery were observed for those younger than 35 years, females, Hispanics, and those whose first provider was a chiropractor. Approximately 42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor (4)."
According to a sample of the literature, Steve Kerr makes a valid point. If you have back problems "rehab, rehab, rehab" and stay away from surgery.
(2) Ambrossi GL, McGirt MJ, Sciubba DM, et al; Recurrent lumbar disc herniation after single-level lumbar discectomy: incidence and health care cost analysis. Neurosurgery. 2009;65:574–8.
(3) Nguyen TH, Randolph DC, Talmage J, Succop P, Travis R; Long-term outcomes of lumbar fusion among workers' compensation subjects: a historical cohort study. Spine (Phila Pa 1976). 2011 Feb 15;36(4):320-31.
(4) Keeney BJ, Fulton-Kehoe D, Turner JA, Thomas M. Wickizer TM, Chan KC, Franklin GM; Early Predictors of Lumbar Spine Surgery after Occupational Back Injury: Results from a Prospective Study of Workers in Washington State; Spine; May 15, 2013; Vol. 38; No. 11; pp. 953-964.