Golden State Warriors Head Coach Steve Kerr may be successful and widely admired for his abilities as a coach and a player. What he may not be is a guy you want to take medical advice from.
Kerr, head coach of arguably one of the best NBA teams, was sidelined during the Warriors’ 2017 post-season games by complications stemming from a spinal fluid leak after a 2015 surgery for a ruptured disc. But the coach and former player did not go quietly onto the bench. He publicly advised anyone with back pain to “stay away from surgery,” and stick to physical therapy instead.
Spine Surgery Complications Rare
Kerr’s experience with surgery to repair a ruptured disc is unfortunate. And so is his counsel to back-pain sufferers, says Denver spine surgeon Jason McGowan, MD. Kerr’s experience, McGowan says, is highly unusual.
“He had an unfortunate complication,” says McGowan, who specializes in spine surgery at Neurosurgery One’s Lakewood clinic. Complications aren’t unique to back surgery – any medical procedure, from getting a cavity filled at the dentist’s office to brain surgery, carries some risk. With spine surgery, the risk is very small, McGowan says.
Discectomy, the spine surgery Kerr had, is one of the most common procedures to relieve back pain, with more than 480,000 performed in the United States each year. Only about 5 percent of those result in a spinal fluid leak, McGowan says. “In the majority of those cases, if the leak occurs during surgery, it’s repaired during surgery, and the patient has no symptoms.”
In a small group within that 5 percent, the leak develops after surgery, likely from weakness in the sac wall that contains the spinal fluid, which results from prolonged pressure on the sac from the ruptured disc, McGowan says. The delayed leaks often can be addressed non-surgically with a “blood patch” or more definitively by surgically repairing the site of the leak.
A tiny subset of patients, however, continue to have symptoms even after the leaks are repaired, McGowan says. “But that number of patients is extremely small.”
Spine Surgery Often Best Option
Studies show that for thousands of people with chronic back pain, spine surgery is the best option, and one likely to offer permanent relief. “In most of those cases, people get significant relief with surgery from what can be debilitating pain,” McGowan says.
One such study, the Spine Patient Outcomes Research Trial, or SPORT study, compared surgical and nonsurgical treatments for patients with a degenerative disc disease. The roughly 500 patients, all good candidates for spine surgery, had either back pain surgery, or non-surgical interventions such as anti-inflammatory medications and physical therapy. The 2012 study found that patients who had spine surgery got better faster. And of those in the non-surgery group, almost half went on to have spine surgery after the study was completed.
Spine Surgery Considerations
Kerr’s advice to stick with physical therapy may be tough for some patients to follow, McGowan says. “If you’re in debilitating pain, how do you do physical therapy?”
If you’re thinking about back surgery, and the publicity surrounding Kerr’s situation has given you second thoughts, McGowan has two pieces of advice:
- “Don’t be alarmed.” Complications such as Kerr experienced are extremely rare.
- Talk to your doctor. “This is where the doctor-patient relationship is important. You can say, ‘I feel like I need surgery, but I need some reassurance.’”
Keep in mind, McGowan says, that just as Kerr’s basketball wizardry puts him in a rarefied group, so does his surgery experience. “He really represents such a small minority of patients in terms of what happened to him. The whole sequence of events shouldn’t discourage people from pursuing surgery.”