Neurosurgery One Blog

Steve Kerr Aside, Spine Surgery Works in Right Cases

Posted by South Denver Neurosurgery on May 30, 2017, 9:40:52 AM

Image of a basketball lying on a wooden floor.jpegGolden State Warriors Head Coach Steve Kerr may be successful and widely admired for his abilities as a coach and a player. What he may not be is a guy you want to take medical advice from.

Kerr, head coach of arguably the season’s best NBA team, is sitting out the Warriors’ 2017 playoff run. He was sidelined by complications stemming from a spinal fluid leak after a 2015 surgery for a ruptured disc. But the 51-year-old coach and former player did not go quietly onto the bench. In April, he publicly advised anyone with back pain to “stay away from surgery,” and stick to physical therapy instead.

 

Spine Surgery Complications Rare

Kerr’s experience with surgery to repair a ruptured disc is unfortunate. And so is his counsel to back-pain sufferers, says Denver spine surgeon Paul Boone, MD. Kerr’s experience, Boone says, is highly unusual.

“He had an unfortunate complication,” says Boone, who recently joined South Denver Neurosurgery from the Mischer Neuroscience Institute in Houston. Complications aren’t unique to back surgery – any medical procedure, from getting a cavity filled at the dentist’s office to brain surgery, carries some risk. With spine surgery, the risk is very small, Boone says.

Discectomy, the spine surgery Kerr had, is one of the most common procedures to relieve back pain, with more than 480,000 performed in the United States each year. Only about 5 percent of those result in a spinal fluid leak, Boone says. “In the majority of those cases, if the leak occurs during surgery, it’s repaired during surgery, and the patient has no symptoms.”

In a small group within that 5 percent, the leak develops after surgery, likely from weakness in the sac wall that contains the spinal fluid, which results from prolonged pressure on the sac from the ruptured disc, Boone says. The delayed leaks often can be addressed non-surgically with a “blood patch” or more definitively by surgically repairing the site of the leak. 

A tiny subset of patients, however, continue to have symptoms even after the leaks are repaired, Boone says. “But that number of patients is extremely small.”

Spine Surgery Often Best Option

Studies show that for thousands of people with chronic back pain, spine surgery is the best option, and one likely to offer permanent relief. “In most of those cases, people get significant relief with surgery from what can be debilitating pain,” Boone says.

One such study, the Spine Patient Outcomes Research Trial, or SPORT study, compared surgical and nonsurgical treatments for patients with a degenerative disc disease. The roughly 500 patients, all good candidates for spine surgery, had either back pain surgery, or non-surgical interventions such as anti-inflammatory medications and physical therapy. The 2012 study found that patients who had spine surgery got better faster. And of those in the non-surgery group, almost half went on to have spine surgery after the study was completed.

Spine Surgery Considerations

Kerr’s advice to stick with physical therapy may be tough for some patients to follow, Boone says. “If you’re in debilitating pain, how do you do physical therapy?”

If you’re thinking about back surgery, and the publicity surrounding Kerr’s situation has given you second thoughts, Boone has two pieces of advice:

  1. “Don’t be alarmed.” Complications such as Kerr experienced are extremely rare.
  2. Talk to your doctor. “This is where the doctor-patient relationship is important. You can say, ‘I feel like I need surgery, but I need some reassurance.’”

Keep in mind, Boone says, that just as Kerr’s basketball wizardry puts him in a rarefied group, so does his surgery experience. “He really represents such a small minority of patients in terms of what happened to him. The whole sequence of events shouldn’t discourage people from pursuing surgery.”

 

Dr. Paul Boone.jpgDr. Paul Boone joined South Denver Neurosurgery in May 2017. He is a board-certified, fellowship trained neurosurgeon with expertise in neurosurgical treatment of disorders of the spinal column and cord. He specializes in complex reconstructive surgical techniques as well as minimally invasive approaches. Learn more about Dr Boone and schedule an appointment.

Topics: spine surgery, minimally invasive spine surgery, degenerative disc, back pain, Denver spine surgeon