9 questions to ask your spine surgeon

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The time has come. You need surgery on your spine. You may feel scared, nervous or excited. You’re likely to have many questions as you weigh your options and make decisions.

Talk to your health care team about how you feel before committing to spine surgery. They are available to answer all your questions and reassure you.

Here are the answers to nine common questions you may have about spine surgery:

1. Am I a candidate for surgery?

Not everyone with back, neck, leg, or arm pain is a good candidate for surgery. Some back pain is caused by problems that aren’t relieved by surgery. In these cases, your surgeon will recommend non-surgical treatments like activity modification, over-the-counter pain relievers, physical therapy, rest, and time.

Other patients may have a surgical problem, but surgery may not be safe for them because they have other chronic, uncontrolled health conditions that make surgery risky. Your surgeon may ask you to exhaust all nonsurgical measures before proceeding with surgery. This could include physical therapy, medication, or injections.

Your surgeon will explain the benefits, alternatives and risks of surgery to you. The potential benefits of surgery must outweigh the personal risks before proceeding.

2. What can I do to improve the chances of surgical success?

There are three factors within your control that can improve your chances of having successful surgery.

Many surgeons won’t operate on your spine until you safely and successfully change these factors:

  • Achieve a healthy weight.
    Maintaining a healthy weight contributes to overall health and well-being, in addition to leading to better surgical outcomes. If you are overweight, your surgeon may ask you to lose weight before the procedure can take place. Obesity can lead to unwanted surgical results and complications, some of which can be serious, such as blood clots.
    It can be difficult to exercise to lose weight if you suffer from back or leg pain. In this case, your surgeon may recommend that you meet with a nutritionist to create a diet and focus on low-impact exercises like swimming.
  • Manage diabetes.
    Any surgery is more risky if you have diabetes. You have a higher risk of cardiovascular complications, infections and wound healing problems. Ideally, your A1C should be 7.5 or lower before your surgery. Your primary care provider or diabetes educator can help you manage your diabetes so surgery is safer.
  • Stop smoking.
    Using tobacco or nicotine products can lead to surgical complications such as wound healing problems and blood clots. It also changes the way the bones heal or fuse together, which can lead to poor healing and symptom relief. In some severe cases, surgery is continued despite these risk factors. This could include spinal cord compression, severe symptoms, or neurological impairment. In these circumstances, the risks of doing nothing outweigh the potential surgical risks.

3. How many of these surgeries have you performed?

Experience and expertise are important when selecting a surgeon. Surgeons may not be able to provide an exact answer over their entire career, but they can usually explain how many similar operations they have performed in the last week or month.

When considering your options, look for a surgeon who specializes in your state and who performs the procedure regularly. For example, about 90% of my practice consists of surgeries to correct degenerative spinal conditions, and I perform surgeries to treat these conditions every week.

4. Will my surgeon be offended if I ask for a second opinion?

No. Never feel bad about asking for a second opinion for any aspect of your health care. It’s your body, and the decision to have surgery shouldn’t be taken lightly.

I encourage patients to ask questions, advocate for their health, and seek a second opinion if it helps them feel more comfortable. Getting a second or third opinion can confirm the best course of action when weighing your decisions. Also, it helps to bring a friend or family member to appointments so you have another set of ears to listen to and another person to think about questions to ask.

5. What are the objectives of my surgery?

An open conversation with your surgeon about what surgery can and cannot do is essential when considering surgery. In some cases, the goal of surgery is to prevent further neurological damage. Other times it may be to relieve leg pain, but it may not treat back pain. This conversation can reduce your anxiety about the procedure, set realistic expectations, and help define surgical success.

6. What can I do to shorten my hospital stay after surgery?

The best way to shorten your hospital stay and speed up your recovery is to follow your preoperative and postoperative instructions carefully. This includes losing weight if necessary, quitting smoking, and taking steps to manage any other chronic health conditions.

Your healthcare team will encourage you to start moving soon after surgery. Years ago, recovery from back surgery included days of bed rest. We now know that this led to slower recovery and more complications. Getting up quickly and walking quickly is important to speed up your recovery and shorten your hospital stay.

As you recover, remember that you are not just recovering from surgery, but also from a lack of mobility. Often people have had months or even years of compensating for their back or leg pain and moving their body in unnatural ways to lessen the pain. During your recovery, you will need to rebuild the strength and stamina lost during this time.

7. Will I still have pain after the surgery?

You will have surgical pain after your procedure. Members of our care team will do their best to manage your pain. Everyone experiences pain differently. Most patients report that surgical pain is significantly less than the nerve pain they felt before surgery.

8. Will I need another back surgery in the future?

This is possible, depending on the reason for your first surgery. Some people have lasting pain relief after surgery and do not require additional procedures. However, degenerative diseases and arthritis are continuous processes that cannot be stopped. These conditions could return and require future procedures.

9. What help will I need after the surgery?

Before surgery, your healthcare team will assess your needs at home. Physical therapists, occupational therapists, and social workers will make recommendations to help you have a successful discharge and a safe recovery after your surgery.

Learn more about caring for your back:

Meghan E. Murphy, MD, is a neurosurgeon in Mankato, Minnesota.

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