The Spinal Surgeries That Didn’t Need to Happen
Back pain is one of the most common health complaints in the modern world. It sidelines athletes, keeps office workers up at night, and fuels a multibillion-dollar health-care industry. For many, the promise of spine surgery — particularly spinal fusion — feels like the only way out. Yet a recent New York Magazine investigation, “The Spinal Surgeries That Didn’t Need to Happen”, shines a harsh light on a disturbing reality: a large number of these surgeries may be unnecessary, ineffective, or even harmful in the long run.
A Human Story at the Center
The article opens with the case of Tiffany Bruce, a woman who endured six spinal-fusion surgeries over the years. Each time she hoped it would relieve her pain; each time she was disappointed. Today, she lives with even greater discomfort and dysfunction than before her first operation. Tiffany’s story is not unique. Online support groups overflow with similar experiences — patients desperate for relief who undergo repeat operations, only to face “failed back surgery syndrome.”
A Boom in Fusions
Spinal fusions were once rare procedures, reserved for catastrophic injuries or obvious spinal instability. But since the 1990s, their use in the U.S. has skyrocketed. For many degenerative conditions, such as general wear-and-tear of the spine, the evidence supporting fusion is weak. Yet the operations keep multiplying.
The result? Many patients go under the knife without strong proof that surgery will help them — and with a significant risk of new complications down the line. Because fusing one part of the spine shifts stress onto the levels above and below, degeneration often continues, creating a vicious cycle.
Why So Many Unnecessary Surgeries?
Unclear Diagnoses
Back pain is notoriously complex. Some people with severe MRI abnormalities have no pain, while others with “clean” scans can barely move. This makes it easy for doctors to justify surgery even when the true pain generator is uncertain.Financial Incentives
In the U.S. health-care system, procedures pay more than prevention. Surgeons are rewarded for implant-heavy, hospital-based operations. Device makers lobby hard, pushing their hardware as the solution. And hospitals encourage high surgical volumes to boost revenue.Cultural Expectations
Many patients want a quick fix. Surgeons are trained to “do something.” The default can become surgery — even when conservative care might work just as well, or better.
Outcomes: The Hard Truth
Studies suggest that up to half of spinal-fusion surgeries fail to provide lasting relief. Patients may get short-term improvement, only to return with new or worsening pain. Some need additional surgeries. Others are left with permanent disability.
In contrast, many people who pursue non-surgical options — physical therapy, lifestyle modification, pain education, targeted exercise — report meaningful improvement over time. Yet these options are harder to access, less glamorous, and less financially rewarding for the system.
A Global Perspective
Interestingly, other countries approach back pain very differently. In some parts of Asia and Europe, surgery is used far more sparingly. Conservative care remains the default, and patients aren’t rushed into the operating room for every degenerative change spotted on a scan.
Where Do We Go From Here?
The article doesn’t argue that spinal surgery has no place. For fractures, tumors, or clear cases of instability, it can be life-saving. But for everyday back pain, the data are sobering: surgery often isn’t the answer.
What’s needed is a cultural reset. Instead of reflexively cutting, the system should:
Emphasize education and prevention.
Make physical therapy, movement retraining, and pain-science approaches widely accessible.
Reevaluate the financial incentives that push patients toward surgery.
Reserve fusion for cases where it is clearly the best, evidence-backed option.
Final Thoughts
Back pain is rarely just a “spinal problem.” It’s a whole-body, whole-life issue, influenced by posture, stress, movement habits, and even social context. Surgery often tries to treat a complex, systemic challenge with a blunt tool.
The stories of patients like Tiffany Bruce should be a wake-up call. Back pain deserves better answers — and sometimes the bravest medical decision is not what happens in the operating room, but what happens outside of it.
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