WHAT ABOUT BACK SURGERY FOR SPORTS INJURIES?
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Nearly 95 percent of all the low back pain occurs in a six by four inch area. This is the place where the fifth lumbar vertebra connects with the base of the sacrum and they both connect to the pelvis by various ligaments.
Specifically, the lumbar vertebrae connect to the sacrum by the lumbosacral ligaments, the sacrum to the iliac crests by the sacroiliac ligaments, and the lumbar vertebrae to the iliac crests by the iliolumbar ligaments. This is the most common area in the back treated by Prolotherapy.
Athletes often come in to our clinic with detailed stories about how an orthopedist performed a discogram and CT scan, MRI, and various other x-rays, and is confident that the athletes have disc problems. It is sad to say, but many patients who have been to orthopedic or neurosurgeons tell us that the doctor never even touched them when making the diagnosis that the pain was caused by a herniated disc or pinched nerve.
Many patients who have all kinds of disc abnormalities that show up on MRI and CT scan, say they didn't even know because they had no symptoms! Scott Boden, M.D., found that nearly 100 percent of people he tested, over age 60, with no symptoms had abnormal findings in their lumbar spines on MRI scans. Maureen Jensen, M.D. and associates published in The New England Journal of Medicine the fact that only 36 percent of people with no back pain had normal MRI scans of the back. The conclusion to the study stated, "Because bulges and protrusions on MRI scans in people with low back pain or even radiculopathy may be coincidental, a patient's clinical situation must be carefully evaluated in conjunction with the results of MRI studies." In other words, DO NOT cut on a person based on MRI studies. Likewise, CT scans find a lot of abnormalities on people who have no back pain symptoms.
The Long Term Risks of Surgery
The back is a weight-bearing structure. It means that when any tissue is removed, whether it is bone or disc tissue, the likelihood of further long-term pain and arthritis is increased. The patient will often undergo a stabilization procedure with rods or bony fusion, including the areas above or below a previously operated on vertebral segment, because the area has become lax and degenerated.
Prolotherapy cures the back pain because it addresses the root cause of back pain--ligament laxity.
Even some athletes are starting to catch on that Prolotherapy can be used as a preventative measure against injury, especially during the off season. By an athlete strengthening their ligaments with Prolotherapy, at least theoretically, they should have fewer injuries during the season. The added strength to the joints should also improve athletic performance.
If an athlete or patient has spondylolisthesis (slippage of one vertebra on top of another), Prolotherapy is still indicated. In 1964, Dr. John Merriman used his over 40 years of experience as an industrial surgeon and compared surgical fusion of vertebral segments to Prolotherapy. Dr. Merriman summarized that conservative physiologic treatment by Prolotherapy after a confirmed diagnosis of ligamentous and tendinous relaxation was successful in 80 to 90 percent of more than 15,000 patients treated. This prevented quite a few unnecessary surgeries.
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