Dr. Kaplan: Functional spinal stabilization can often be done even in patients with herniated discs to avoid back surgery. The goal is to get the back as strong as possible using the patient’s own muscles to do what a surgeon would do with bone grafts and rods. The nice thing about this approach is that you have not destroyed any anatomy; you have not put any foreign hardware in and if successful for that individual, they are going to not only improve from this particular pain episode, but hopefully prevent a future injury.
In contrast, if you immediately jump to a surgical intervention, for example, a fusion at the L4-5 level, you are going to put increased force and pressure on the disc level above and below the fusion and the structures on the sides. You may have fixed the problem at L 4-5, but now you have increased irritation and increased pressure at L 3-4 and L5-S1. Guess what happens? For a number of years the person is successful. They get back to work, they do things, but put more force on the adjacent lumbar levels and sacroiliac joints. This can lead to additional problems in these other areas and potentially the need for other interventional procedures. In contrast, with functional spinal stabilization, all the muscles are stronger, not just at the L4-5 level, but above, below and to the sides as well.