Is surgery the only option?

In the August 3, 2016 “The Upshot” column in The New York Times, author Gina Kolata reports on the rationale behind common surgeries, from meniscus to spinal fusion to vertebroplasty. When compared to drug trials, she reports, surgeries lack similar checks and balances. Outcomes have relied heavily on provider and patient impression of success, rather than statistical measures. This impression may be a type of placebo, as either the provider or patient has such a strong desire for improvement. Spinal fusion is one type of spine surgery that did not meet the test of statistical improvement and is now denied by many insurers. Conservative care options such as physical therapy (PT), chiropractic, acupuncture, massage, exercise therapy can be suggested to patient as a first line of care before surgery is considered.