It made good sense. Unfortunately, it was wrong. The lordosis of the spine does change with muscle spasm, but a loss of lordosis is seen too often in normal individuals to be a true discriminator. Studies of completely healthy individuals have shown that by age 40 most people will have some degenerative joint disease but that the degree does not correlate with symptoms. Narrowed disk space also appears to be a natural aging process that is unrelated to the presence, absence, or severity of back pain.
Relative indications become a negotiated decision between clinician and patient.
That low-back pain typically resolves within a few months is little solace to the financial head of a household who faces the prospect of economic disaster or to a professional athlete who risks losing valuable playing time. Surgical intervention is an option for such patients, even though conservative measures are likely to be just as effective if the patient is willing to endure a more lengthy recuperative course. The last 15 years probably saw more surgery than was optimum. In addition, the growing number of individuals for whom postoperative disability proves devastating has dampened enthusiasm for surgery. Because patients who undergo laminectomy often don't address the lifestyle factors that contribute to their condition, they frequently undergo laminectomy at another disk level later.