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Established 1969 - over 40 years experience in treating spinal disorders
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The Fallacy of Spinal Surgery
Translated from the Polish research papers

by Mr B.M. Luklinski
MSc Medical Rehabilitation; MSc Physical Education; Dip Home Med.

The Fallacy of Spinal Surgery is based upon a widespread modern clinical deception involving false surgical concepts and applications.

The fallacy of spinal surgery has been well documented through medical research data carried out by Prof .A.Nachemson in NECK & BACK pain - The Scientific Evidence of Causes, Diagnosis and Treatment. His research demonstrably proves that spinal surgery is totally ineffective, despite the regrettable historical fact of it being carried out so pervasively. The reason for the prevalence of surgical failures which have brought untold misery to probably hundreds of thousands of patients around the world - some would call them guinea pigs - is due to the underlying false concepts and applications which attempt to address the symptoms and not the causes of a spinal condition;  furthermore, so called surgical diagnosis is invariably clinically FALSE, based they are based upon MRI scans, instead of upon a dynamic physical examination.

A blind man (aka spine surgeon) cannot see the road ahead; he subjectively addresses conditions which he does not clinically understand, because they do not fall within his sphere of study, and which might otherwise help him to understand. Surgeons are trained to cut out or trim body parts, a bit here and a bit there; and then to patch up the result as best they can. They have not studied the biomechanics of the spine and the effects of spinal surgery on the post-operative health and stability of the spine. It does not in any case serve their purposes financially to turn their patients over to other practitioners who might understand and who might be able to effect a cure or at least bring about an improvement without any surgery!

Occasionally, a surgeon may put health before profit and refuse to carry out surgery, but these instances are very rare.

Desperate and ignorant patients are more often than not subjected to useless procedures in the hope of becoming cured with no further pain. Surgical reassurance that goad patients into agreeing operations are groundless, or at worst are based entirely upon false statistics produced by individual surgeons/hospitals without any scientifically based data. A closed-shop mentality of "we know best " is a further guarantee of operational failure.

Listen to what other experts say: Prof Porter (University of Aberdeen ) says that there are less than 20 specialistically trained spinal surgeons in UK - the remainder are nothing of the kind! Nevertheless "they carry out life-threatening surgeries for non-life threatening conditions. Surgical 'enthusiasm' - if indeed it is genuine and not simply just another deception practiced on the unwitting patient - is based upon clinical ignorance (MRI false scan diagnosis ) and is financially motivated.

In the USA ( which has the lowest level of spinal care and skill ) 650,000 operations (250,000 lumbar ) are carried out every year earning over $3.5 billion! Such a 'commendable' practice results in hundreds of thousands of permanent life-long disabilities necessitating further and continuous expenditure in pain managment clinics. The average cost of surgery is $50,000 although "99% of spinal disorders are curable non-invasively through established procedures of Orthopaedic Medicine." "Spinal Surgery should be confined to 0.3 -0.5 % only." Surgeries carried out are usually based on clinically false interpretations of MRI scans the reliability of which is only "25-40 %."

The only valid procedures are those based on a study of the patient's clinical history, and a physical examination. The human spine is unique for life and should be treated ONLY via well established procedures of Orthopaedic Medicine, not a spinal quack masquerading as a surgeon. Any surgery destabilises the whole spine through interference with the bone (fusion, laminectomy), or soft tissues (disc replacement, discectomy) causing irreversible  and permanentl damage to the structural stability, while neuro-muscular soft tissue removal  invariably results in chronic pain.

It is simply naive to claim that spinal surgery is beneficia:l so-called "surgical de-compression " is another fallacy as it causes adverse effects via re-compression! Fibrotic tissue scarifications are a well established fact, as there is no room for any freely formed mass between the disc rim and bone, which has a tiny space only for nerve roots. The distance between the outer rim and nerve root sleeve of the spinal cord outlets is only 1.2-1.5 millimeter, which is the main reason for failed surgery and chronic post-operative pain. The newly formed fibrotic scars, which are inevitably formed as a result of the incisions of the surgon's knife, are dense and their growth is spontaneous, resulting in recompression/irritation of nerve root.

Spinal surgery not only destabilises the intersegmental level, but also other spinal levels and ultimately the whole spine, which must compensate accordingly through the discs and soft tissues etc. Such an adjustment and reaction causes undue pressure elsewhere resulting in a progressive disc disease (bulgings, herniations, prolapses). Postoperative complications are common causing a localised variety of symptoms  and also distal pain in the spine/limbs or both. Surgeons can easily operate on a clinically wrong level based upon an assumed diagnosis. A commonly overlooked issue is one of bone deformit, eg a slightly shorter limb that has caused an imbalance in the pelvis and spine - which means that any surgery on a disc is doomed even before it takes place! The disc appears to be the problem whereas in fact it is simply a slightly shorter leg, so when the disc is cut out and a cage is affixed to the spine, the patient's spine is no longer able to make any necessary adjustments which in itself causes further pain.  Simple physical therapy by a qualified spinal specialist can resolve back pain caused by 'short leg syndrome' - but a surgeon cannot and never will be able to do so using his cutting tools and drills.

An acccurate clinical diagnosis is complex to formulate and requires expert knowledge of all those involved.

It is accepted that spinal biomechanics is a specialised field of study, and surgery causes a permanent damage to the whole structure in every intervertebral level, resulting is a chronic pain and other symptoms .Daily changes of the spine length are 12 mm in females and 18 mm in males. Night lying down rest compensates those differences in young subjects ,but ageing is counteractive and does not. Mobility changes with age from 80% in young subjects  to 25 % in old age ,although about 20 % mobility  is maintained at L4-L5 level. The front part of vertebra supports body mass  and back part controls motions. Stability of the spine must exist in order to maintain maximum motion. If ,a disc ( nucleus pulposus) central part has to move accordingly then spinal duras and nerve radicals ( roots ), are affected into and outside those duras.The spinal cord ends at L2 level and below exists as cones terminalis and cauda equina.   Discs are subjected to non-stop loads (inter-joints are not directly involved in in a weight bearing ) ,however the upright position is essential to be maintained at all times( all spinal curvatures ), as it reinforces vertical stress by 17 times( as compared to a straight vertical line ).The average spine stress is 350 kg ,in cervical spine 113 kg ,thoracic 210 kg,lumbar 400kg. However the standard stresses are ( apart from sport activities )are lesser and are in cervical spine 50 kg ,thoracic 75 kg, lumbar 125 kg. Spine durability is disproportionate to the time of stress, constant weight bearing causes soft tissues stiffening and lessens spinal durability, vibrations causes similar reactions. In the lumbar spine the posterior part of discs are higher likewise in cervical spine ) and vertical mobility pressure lays 5 mm from anterior part towards dura matter. During flexion disc moves forward, in extension moves backward, those movements cause narrowing of spinal canal (stenosis).Stenosis is  commonly operated surgically, which is false. All discs contribute to a 25% of all spine ( discs heights are in cervical 2-4 mm, thoracic 6-8 ,lumbar 10mm). NUCLEUS PULPOSUS occupies 50-60% of the whole spine and the central line of all spinal joints lays in the middle of disc. Any supporting disc changes resultin the WHOLE SPINE pathological biomechanics .Any spinal surgery will results in IRREVERSIBLE DESTABLISATION!

( bone structures and all neuro-muscular tissues - visceral organs ),causing permanent skeletal and metabolic changes. The nucleus pulposus contains 88% of water ( at birth ) ,at age of 18-en 80%,in the old just 69% ( 20% of water are lost from the age of 60-ty,extra 10% from the age of 70 -ty).From the age of 30-ty discs are not directly nourished only via osmosis process. Discs are subjected to a continuous pressure.particuraly in standing ( ratio 1-1body weight )and sitting-20% more and leaning forward to 40%, also tension of trunk extensors is present even during sleep. Any trunk flexion below 30 degrees involves ligamentous strain only ,no muscles are involved. A person of 70 kg body weight is subjected to 142 kg load( sitting ),in standing the load is 99kg,lying down ( sleeping )on the back the load is 20 kg( all above factors are applied to L3 vertebra).Intradiscal pressure is 145-210 psi ( sitting ),in standing less 30%.lying on the side is less 50%,flat on the back is 10-20%less than sitting. Pressure on the disc fibres( annulus fibrosus )is symmetrically distributed, however because of disc shape the load bearing in the posterio-lateral can exceed 5 times existing pressure ( that is why all injuries occur in such position ),ageing causes lesser disc bearing and involves more loads, a damaged discs onto facet joints. All physical activities cause shortening of disc height and more damage to annulus fibrosus( outer disc rim ).eg.50 kg weight causes 0.5 mm outer rim elasticity, at 100 kg weight it is 0.75%,a damaged disc has 0% extra elasticity. The lumbar loads are increased via upper arms long leverages,eg lift of 45kg in counter balanced via trunk muscles of 675 kg strength! Likewise simultaneous disc pressure is 750 kg Any front lifting is compensated by trunk muscles strengthen lift of 90 kg causes disc pressure of 1000 kg (L5-S1 level). The maximum stress factor of each lumbar vertebras is 900 kg. Muscule strength is vital in particular rectus abdominalis ( diapghram flexor ) unloads 50% of back stress ,abdominal obliques are of lesser assistance, as those muscular groups affect breathing during loads lifts,witholoding breaths assists, though breathing itself does not .Above facts are sufficient to support FACTS that 99% of all spinal disorders are mechanical in origin, therefore the ONLY EFFECTIVE curability is manual therapy via scientifically proven ORTHOPAEDIC MEDICINE/MANIPULATIVE THERAPY /SPINAL REHABILITATION. The ONLY effective procedure is as follows :

1.Manual MOBILISATION (SKELETAL DECOMPRESSION)

2.Specific spinal exercises (self-mobilisation via BACK RACK).

3.Any other therapy is a meaningful regardless of medical training.

ALL spinal surgeries are groundless being based upon FALSE concept and application.

The FACTUAL fallacies have been proven by A.Nachemson data research, which summaries as follows:

1,Surgical " diagnosis " are false  and ineffective , surgical "success" claims are FALSE.

2.Spinal surgeons do not and can not diagnose, except relying on FALSE mri scan.

3 Mri scan is clinically FALSE - worthless.

4. 99% of spinal surgeries are carried out needlessly for profit or through clinical ignorance.

5.Surgeries address symptoms, not a cause.

6.Lay patients are brain washed  for surgery under "surgical prestige" ?

7.Hospitals are useless for spinal disorders ( no specialists )

8.ALWAYS seek a clinical spinal Specialist (instead a "related " one ! ).

9. 85% of spine related tests have no clinical significance.

10.Clinical " quacks " are common regardless of qualifications.

11.All types of surgeries :artificial discs, discectomies, minimally invasive ( ! ), idet, fusions are INEFFECTIVE... just keep surgeons busy! (never mind fees).

12.All surgeries result in a FAILED BACK SYNDROME! (spinal chronic pain, disability - life complications).

EFFECTIVE are:

SPINAL MOBILISATIONS (99%) followed by a preventative SPINAL REHABILITATION.

Summary of medical data FACTS: (Nachemson);

Conservative treatment of ACUTE -sub -ACUTE lowback pain:

INEFFECTIVE are:

1.Analgesics, parcetamol, aspirin. non-steroidal anti-inflammatory-ibuprofen, diclofenac. muscle relaxants, benzodiazepine, antidepressants, colchicine, systemis steroids (all produce side effects !).

2.epidurals injections, bed rest (side effects!), specific back exercises (flexion, extension, aerobics, strenghtning).

3.Manual therapy (Chiropractic, Osteopathic MANIPULATIONS are contraindicative (damage) with a neurological deficit or under general anesthesia very dangerous causing serious damage!)

MOBILISATIONS are EFFECTIVE /safe - staying active.

4.Physical modalities (PHYSIOTHERAPY): ice, heat, short wave diathermy, massage, ultrasound.

5.TENS ,traction ,lumbar corsets/supports (all muscular), acupuncture, behavioral therapy.

Recommendation for a treatment of acute back pain:

Stay ACTIVE (some paracetamol) MOBILISATION/manipulation up to 6 weeks. Spinal Rehabilitation essential

Chronic low back pain (conservative treatment):

1.Analgesics (short relief - symptomatic ?)

2.Non-steroidal antiflammatory drugs (NSAID-S), piroxicam, indomethacin, ibuprofen, disclfenac, ketoprofen, naproxen, diflunisal) -all little help, but side effects/gastrointestinal.

3.muscle relaxants and benzodiazepines (short/symptomatic relief - adverse side effects). Antidepressants-ineffective.

4/Epidural steroid injections - ineffective

5.Back schools - ineffective

6.Behavioural Therapy (relaxation, coping, imaginery) - ineffective

7.Electromyographic biofeedback, traction, orthoses. TENS, acupuncture, spa therapy (water) - INEFFECTIVE

8.Effective - multidisciplinary standard rehabilitation, exercise therapy - effective

Recommendation; MANUAL THERAPY - exercise.

DRUGS to be avoided.

SURGICAL treatment of lumbar disc prolapse and degenerative disc disease (ddd). Are All INEFFECTIVE.

discectomy-microdiscectomy, percutaneous-laser-minimally invasive (endoscopic), chemo-nuclosis.

FUSION (severe disc degeneration, malalignment,instability) - causes long time spine disability resulting in intersegmental spinal collapse (destabilisation) - disc herniations in the whole spine, recompression causes chronic damage, decompression surgery (spinal root canal stenosis)

Fusion plus decompression (laminectomy, spondylolisthesis).

All above are IRREVERSIBLE and cause a PERMANENT spine damage (life PAIN and drug dependency) - regardless of techniques applied! All above cause FAILED BACK SYNDROME!

ACUTE and SUB-ACUTE NECK PAIN (non-surgical treatment)

The following modalities have been tested and found to be INEFFECTIVE.

spray and stretch (vapocoolant spray followed by passive stretching),

laser therapy,

infrared,

electromagnetic therapy

TENS (trannscutanous electrical nerve stimulation)

acupuncture,

traction,

cervical orthoses, excercise, collars, (little-moderate help).

EFFECTIVE - Manual Therapy (MOBILISATION-manipulation combined with exercise).

CHRONIC NECK PAIN (non-surgical treatment)

Ineffective are: steroid injections, muscle relaxants, behavioural therapy, acupuncture, traction, cervical collar, laser(?), electromagnetic therapy, prior exercises (short term effective), water pillows (?), physical therapy (moderate effective).

Manual Therapy -ineffective for non-specific neck pain.

Surgical treatment of neck pain (INEFFECTIVE)

The following conditions were analysed:

Nerve root compression (entrapment) caused by spondylitis with hyperthropic facet and uncovertebral joints and a bulging disc.

The mechanisms why spondylosis and disc herniation cause is still unclear, as direct pressure on nerve root does not cause pain (algogenic substance or oedema may be responsible for pain mechanisms). Cervical radiculopathy are caused more by spondylotic lo changes than by pure disc herniations. The most affected levels are C5-6 and C6-7. The pain location is determined by the level of the compressed root. The results published by surgeons were their "own" as excellent, fair etc -70-80% ( ! ? ), purporting to be successful ( ? ! ), however apart from a HISTORICAL VALUE (!) as being carried out, those are FALSE!

Disc fenestraction, discectomy, bone cement fusion, bulging discs, whisplash injury, RE-OPERATIONS are groundless and FALSE!



I do hope that my 45 years experience of clinical practice is obvious and that any spinal surgeries are irreversible, and could lead to life disability and should never take place.