Surgery Is Damage to Accomplish a Goal

By /

Most of my patients view surgery as like getting a part fixed in their car. A part wears out, so you replace it or “fix it” with a new one. As I spoke to a patient this week about pursuing back surgery or continuing to try to avoid it with orthobiologics, I was struck how he didn’t understand that back surgery would damage his spine. He didn’t get that the procedure would only be worth it if we had no other option and if the damage from the surgery was less than the good we thought it might do. At that moment, sitting there, struggling to get him to understand, I coined a phrase: “Surgery is damage to accomplish a goal.”

Surgical Damage

Let’s say that you have a nerve that’s being compressed by a disc bulge. If a surgeon goes into “fix” that problem, he or she must first cut through the muscles that stabilize the back. The act of just placing a retractor tightly against those muscles to allow the surgeon to visualize the area will also damage them in direct proportion to the pressure and the amount of time that the device is in place. If the surgeon removes the part of the disc pressing on the nerve, the structure of that disc will be forever compromised as it won’t grow back. If the surgeon must remove part of the local bone to open up the area, then the whole vertebra will be less stable.

Let’s take this surgical damage concept to the knee, shoulder, and ankle. A torn piece of a knee meniscus can’t be removed without also increasing the forces on the cartilage. When a surgeon removes the biceps tendon because where it attaches is torn, it will negatively change the way that biceps muscle and the shoulder work. And so the examples continue from the ankle ligaments replaced with tendons to an ACL replaced with a hamstrings or patellar graft. There is no surgery-free lunch, meaning it’s all controlled damage to accomplish a goal.

Join us for a free Regenexx webinar.

Is the Damage Less Disabling Than the Goal?

This, of course, is the billion-dollar question. First, the answer is very easy when research shows that the surgery doesn’t produce positive results better than physical therapy or a placebo. So for these surgeries, unless it’s a unique scenario, no amount of damage is acceptable:

Reducing the Damage

One way to move the balance of damage and outcome into your favor is to reduce the damage. So for the spine patient above, we discussed getting a true muscle-sparing, minimally invasive surgery where they would remove the least amount of disc and bone feasible. This is why we practice interventional orthopedics, allowing us to get stem cells and platelets to the right spot using an injection that does no or little damage. This is also why we’re working on the next generation of injection-based tools that will replace surgery, allowing us to do things through needles that used to only be possible with surgery.

The upshot? Surgery is damage to accomplish a goal. There’s just no way around it; modern orthopedic surgery is often like a bull in the china shop. None of these procedures are like replacing a worn-out part with a new one. In fact, they all involve damaging the musculoskeletal system to some degree. So the million-dollar questions is always, is the amount of damage this surgery will cause worth the end game?

Join us for a free Regenexx webinar.

If you have questions or comments about this blog post, please email us at [email protected]

NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.

Get Blog Updates by Email

By submitting the form, you are agreeing that you read and consent to our Privacy Policy. We may also contact you via email, phone, and other electronic means to communicate information about our products and services. We do not sell, or share your information to third party vendors.

Category: Latest News
Copyright © Regenexx 2021. All rights reserved.

CONTACT INFORMATION

Address

9035 Wadsworth Pkwy #1000
Westminster, CO 80021

Phone

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.

LinkedIn
Email
TO TOP