Has your doctor suggested back surgery to relieve back and/or leg pain? In my experience, everyone reacts differently to such a recommendation. For some people it prompts a list of questions about everything from the details of a surgical procedure to complication rates to how many surgeries I’ve done. Others don’t ask anything at all. While there are no “right” questions—nor any particular number required—there are a few questions you should ask before back surgery that could help you make a more informed decision about how and when to proceed.
4 Questions To Ask Before Back Surgery
I’ll start with the most important question—the one I’d ask first before spinal surgery:
1. What would you do if you, or a member of your family, were in my situation?
It’s a valid question, and one that essentially asks the surgeon to factor in his or her wide breadth of knowledge about the surgery, the options available, and the outcomes. They know more than you, and even though they may have conveyed as much knowledge to you previously as possible, it’s worth asking them to consider the situation from a different angle. Keep in mind, however, that even though they can look at a set of X-rays and examine them objectively, they cannot walk in your shoes—which means they aren’t able to understand your level of pain or the way it’s impacting your life. So take their answers under advisement, but consider it within the context of your specific situation.
2. How many back surgeries have you done, and are you comfortable with performing this procedure?
Spine surgery also falls under the umbrella of orthopedics and neurosurgery, and, back in the day, even general surgeons operated on spines. Today, the best spine surgeons are focused exclusively on the spine, which is exactly what you want—someone whose sole focus is on spinal surgery.
You also want a practiced, experienced surgeon who is comfortable doing your particular procedure, and has done it often. You may think that going to a top-rated medical facility will guarantee you an experienced spine surgeon, but that isn’t necessarily the case. They also employ excellent academics and researchers who do surgery only occasionally. As a general rule, the best surgeons are in private practice because they operate all the time. And you’re always better off with someone who’s done six spine surgeries a week for 20 years over someone who’s done three a month for two years. Like anything else, practice improves performance.
Another question I’d ask, specifically before spinal fusion surgery, is:
3. What is the success rate of this procedure?
It’s important for your doctor to make you aware of your recommended surgery’s track record for success before you make a decision to proceed. For example, spinal fusions have a high failure rate; patients often need additional surgery in the years following the procedure. Success rates, however, aren’t always the whole story—sometimes a particular procedure is simply the best option for a certain condition.
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One example of that is scoliosis surgery. Degenerative scoliosis can happen to anyone when their spine wears out, and fusion is often a necessary procedure for this condition. In the past, multiple-level fusions, or “long” fusions, were common for scoliosis—until it was determined that long fusions work in the short term but not in the long term. (They often lead to breakdowns of the levels on either end.) Before scoliosis surgery, ask questions about how many levels will be fused, and whether a “short” fusion might be a viable alternative.
4. Are there alternatives to this procedure?
Unlike an appendectomy, the recommendation for back surgery is subjective. It’s rarely an emergency, and there are usually options that are tried first to address the pain. This question asks the doctor to consider whether waiting is an option (80 percent of patients with back pain see some improvement after six weeks); whether all conservative treatments have been tried; and whether there may be some other option for treating it, for example, keeping a fusion to a single-level rather than a multi-level, or trying a new innovation that’s less well-known. Your physician should also take into consideration your age and activity level, which should have some bearing on the path ahead.
If fusion surgery is recommended for you, make sure you’ve explored the alternatives.
Fusion is the traditional solution for back and leg pain, but it isn’t necessarily the best option for everyone. Today, patients have another alternative to consider: BalancedBack® Total Joint Replacement. To find out more about the procedure and whether or not it’s right for you, visit our website or talk to us.