Surgical therapy of backache

: Apart from disc prolapse, there is a range of other disorders associated with low back pain, for which, when all conservative efforts have failed, surgical treatment should be offered. It must be emphasized, however, that the indication for surgery needs to be rigorously applied, since the most common cause of failure of surgical therapy is an erroneous surgical indication. Here, the clarification of the cause of the pain and not the diagnosis per se is decisive. In particular in degenerative disorders of the lumbar spine in the elderly, the diagnoses established often have little pathological value. Unfortunately, in many cases the real cause of low back pain still cannot be clarified with certainty. Our experience to date, however, in particular with the use of modern implants, shows that, in cases of lumbar spinal stenosis especially, tumors and pronounced segmental instability, excellent results can be achieved with surgery.