Normally, lower back pain is caused by degenerative disc disease. If your brother has already undergone physical therapy, chiropractic treatment, injection therapy and medications, he might be a candidate for surgery. It depends upon how many levels are involved, his desired lifestyle after surgery, his expectations and if a surgical workup indicates he is a candidate for surgery in the first place. There are spine surgeons that won’t do surgery for lower back pain and if he found one with that philosophy, he should look for another that will consider him for surgery. Check the website for a discussion of discograms which might be the next test he would need in the hands of another spine surgeon.
Sincerely,
Dr. Corenman