Surgery offers better odds than nonsurgical treatment for low back herniated discs
For patients with low back pain and other symptoms caused by herniated discs, surgery provides better results than nonsurgical treatment, according to a study in the December 1 issue of Spine. In the 4-year combined as-treated analysis, those receiving surgery demonstrated significantly greater improvement in all the primary outcome measures.
That research report doesn’t surprise me. Over the years I have represented many clients who had herniated discs due to back injuries in various sorts of accidents. While there are stories of medical success and failure in both surgical and nonsurgical approaches, the general pattern of outcomes has led me to develop a bias in favor of decisive action without excessive delay.
Personal experience contributes to that. bias In 1990, I developed a herniated disc in the lower back at L5-S1, probably due to delayed effects of a car wreck a few years earlier combined with the strain of sprinting at an airport with about 100 pounds of what lawyers jokingly refer to as "briefcases." Though the pain was immediately excruciating, I had a case to try a few weeks later and was too stubborn to deal with my own medical issue til we got our judgment ($1.75 million). For a month I worked through constant pain that was like boiling oil pouring down the back of my right leg, Then, on Sunday after completion of the trial on Friday, I woke to find that the pain had stopped, but I had lost most use of my right leg.
Fortunately, I had a connection with one of the top neurosurgeons practicing in Atlanta at that time, Dr. Nettleton Payne. He saw me on short notice, an ordered an MRI that showed "all the jelly was out of the donut." That meant there was nothing to do but operate, so I didn’t have to endure months of conservative therapy. Fortunately, Dr. Payne had a brief opening in his schedule later that week, prior to catching a plane to surprise his son who was cycling across the continent. Dr. Payne performed a discectomy without fusion.
Within two months after surgery I was jogging a little. Within six months I had ceased to have pain or tingles down my leg. Eventually I ran marathons with no difficulty related to the back — though a general lack of athletic aptitude and inadequate training led to poor marathon times. Now it has been 18 years since I had low back pain other than an occasional muscle strain.
My personal experience and most of the experiences reported by personal injury clients over the years is consistent with the report in Spine, that for low back herniated disc injuries, surgical outcomes generally beat nonsurgical outcomes. However, inidividual results do vary. Not everyone has a surgeon as skilled as I did, and individual injuries to differ.
While I had a good outcome with my own herniated disc, I have also experienced the painful and debiliatating effects of the injury. These professional and personal experiences have proven helpful to me in proving the impact of back injuries and optimizing monetary recovery for clients who have such injuries.
Ken Shigley is a trial attorney in Atlanta, Georgia who has been listed as a "Super Lawyer" (Atlanta Magazine), among the "Legal Elite" (Georgia Trend Magazine), and in the Bar Register of Preeminent Lawyers (Martindale), and is a Certified Civil Trial Advocate of the National Board of Trial Advocacy,. Mr. Shigley has extensive experience representing parties in trucking and bus accidents, products liability, catastrophic personal injury, wrongful death, brain injury, spinal cord injury and burn injury cases. He served as chair of the Southeastern Motor Carrier Litigation Institute, is on the National Advisory Board for the Association of Interstate Trucking Lawyers of America, and is a frequent speaker at continuing legal education programs for the Interstate Trucking Litigation Group of the American Association for Justice. Currently he is Secretary of the 40,000 member State Bar of Georgia.