By Peter Derman M.D., M.B.A.

Spine problems are extremely common. In fact, 62% of U.S. adults have sought treatment for severe neck or back pain. This often excruciating and unrelenting pain forces many people to consider spine surgery.

Advances in medicine have made these operations safer than ever. However, any surgical procedure carries some risk. In order to help with the decision-making process, here are several questions every patient should ask before opting for spine surgery.

The 6 Most Important Questions to Ask Before Spine Surgery

1. Are there any remaining alternatives to surgery?

As with any procedure, the decision to embark upon spine surgery should not be taken lightly.

While surgery often produces outstanding results in the right patient, it should be considered a last resort. Non-operative strategies such as physical therapy, anti-inflammatory medications, and achieving a healthy weight should be first-line treatments and are frequently successful.

Steroid injections targeted to the areas around compressed nerves might be considered next if symptoms remain. In uncommon cases of severe nerve compression or traumatic injury, your doctor might recommend surgery in lieu of these non-operative measures, but this is a relatively infrequent scenario. Before proceeding with an operation, ensure that your surgeon knows what treatments you’ve already had so that you can confirm that all non-operative strategies have been exhausted.

2. What surgery is being recommended?

If you ask five spine surgeons how to manage a given problem, you might get seven opinions. Because there can be such variability in treatment strategies, it is important to know exactly what surgery is being recommended and why.

Some spine issues are amenable to decompression alone while others may necessitate fusion. To further complicate matters, strategies such as laminoplasty and disc replacement exist and may represent a middle ground. Even once surgery has been decided upon, there are multiple techniques for accomplishing each, ranging from the traditional to the minimally invasive.

You don’t need to master the intricacies of the procedure, but you are an integral part of the team and should understand the plan. If you continue to have reservations after speaking with your surgeon, a second opinion may be helpful.

3. What sort of relief can you expect from the surgery?

The goals and expected outcomes of spine surgery may vary depending on the problem. The spine and nervous system are complex structures. Issues such as disc degeneration, arthritis, and disc herniations can affect multiple different sites, producing a wide variety of symptoms affecting the neck, back, arms, and/or legs. Some of these symptoms are more amenable to surgery than others.

If an operation is recommended, it is important to understand the goal of the surgery. Is it primarily to address pain shooting down the legs or arms? How much relief of neck or back pain can be expected? Is the aim to prevent symptoms from worsening or can you anticipate improvement? Asking these questions up front will help you decide if surgery is right for you and will help set realistic expectations from the start.

4. What are the risks of surgery?

Spine surgery may sound daunting but can be consistently performed in a safe manner. However, there are inherent risks to any surgical procedure. Discussing these risks with your surgeon can help you decide for yourself whether surgery is worth pursuing. Many patients initially focus on rare, worst-case-scenarios when first considering spine surgery, so a realistic understanding of the risks often allows them to feel more at ease.

5. What is the recovery like after surgery?

The postoperative recovery period is also a critical time for patients. This is where the patient navigators at Texas Health Spine & Orthopedic Center can be of great service.

Don’t wait until after surgery to make arrangements and accommodations for life during the recovery period. Depending on the operation and your personal circumstances, securing child care, a helping hand at home, and/or time off work may be advisable. Ask your surgeon about how long patients undergoing this procedure typically stay in the hospital and when they return to activities such as driving and work. While there is some variability from person to person, having an idea of what to expect will allow you to prepare in advance.

6. What factors make for better spine surgery outcomes?

We can’t always control the cards we’re dealt, but there are certain modifiable pre-operative factors that can help improve the outcomes of spine surgery. Achieving a healthy weight, abstaining from tobacco use, minimizing opioid medication intake, controlling diabetes, and maintaining a positive attitude all contribute to the ultimate success of the operation. Rather than focus on what’s getting you down, work to optimize these factors before surgery to help ensure that the operation will get you back to the activities you enjoy!

 

Dr. Peter Derman is an orthopedic spine surgeon who practices is in the North Texas area. Click here for more information on Dr. Derman.

Physicians who are members of the referral line practice independently and are not employees or agents of Texas Health Spine & Orthopedic Center.

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