Radiologic considerations before getting back surgery – The Medical Consultant

Radiologic considerations before getting back surgery

Back pain can be relentless and can prevent you from carrying out your normal daily routines not only in your personal life but also in your job.  It is therefore not uncommon to want to get better as soon as possible which often is the driving force behind seeking back surgery.  However, it is important to know that 90% of back pain will improve on its own with or without surgery.  Therefore, most of the time you should wait 6 weeks before you decide to get advanced imaging such as an MRI of your spine.  There are a few exceptions for which you will want to get imaging sooner which would include pain after a trauma, loss of bladder or bowel function, numbness in your genital area or legs, or inability to walk or stand.  If you have these symptoms, it could indicate a reason you would need to have imaging sooner.

The reason you should not obtain advanced imaging prior to 6 weeks is that the findings of the imaging may not actually correlate with your symptoms and can lead to unnecessary surgeries. In fact, studies have shown that not only does the incidence of asymptomatic disc bulge and protrusion increase with ageing but that it is pretty high to start with.  It was shown that about 30% of individuals have a disk bulge or protrusion by age 20 without any symptoms.  By age 80 the percentage of people with a disk bulge or protrusion increases to 43% in patients with no symptoms at all.

These misleading findings on MRI can be a large contributor to patients having pain that is worse or not relieved after back surgery. If you have an MRI performed prior to 6 weeks and it shows a disk bulge, then you really do not know if that is the cause of your pain.  However, it is not uncommon for surgeons to recommend surgery for a disk bulge or protrusion because, after all, that is what they do.  Always consider a second opinion of your MRI by a specialist radiologist at The Medical Consultant before you decide on getting surgery and unless you have one of the above exceptions for waiting give your pain 6 weeks to improve on its own.  The Medical Consultant gives you the right diagnosis by an unbiased radiologist specialist.


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