The news that you may need spinal surgery can create many emotions -- hope that you may find more pain relief, fear about the procedure and recovery, and confusion about what to do next. One thing you might wonder is what you can do as a patient to make the decision-making process about whether to have spine surgery a productive experience.
Know the Cause of Your Chronic Pain
Identifying the cause of your pain is different from finding out what is anatomically wrong with your back. For example, you may have a herniated disc that shows up on an MRI scan, but if that is not the cause of your pain, then surgery for the herniated disc (usually a microdiscectomy) will not help you find pain relief. You, and your doctors, should be able to articulate the precise pain generator before surgery is even considered. See also Getting an Accurate Back Pain Diagnosis. Many practitioners believe that one of the most common causes of "failed back surgery syndrome" (continued pain after surgery) is an improper diagnosis prior to surgery. See also Failed Back Surgery Syndrome (FBSS).
Get a Referral to a Good Spine Surgeon
Ask your current treating physician to refer one or more good spine surgeons. Because there's no good way to absolutely evaluate and compare surgeon competencies, your physician will likely have to use word of mouth and anecdotal data. However, referring physicians can get a sense of the surgeon's qualifications through knowing whether a surgeon has been fellowship trained in spine surgery, the number of back surgeries performed by the surgeon, and whether spine surgery is a significant part of the surgeon's practice. And don't be afraid to ask your physician: would he or she let the spine surgeon do surgery on one of his or her own family members? See also Getting a Referral to a Spine Surgeon.
Be Well Prepared for Your Medical Consultation
When you're in pain, it can be difficult to describe your situation to the doctor in a complete, concise and accurate manner. Meeting a spine surgeon can also be overwhelming and intimidating. Therefore, researching likely questions ahead of time can help. Be prepared to discuss your medical history (including your family's history), details about your pain and your expectations about the surgery itself and its results.
Evaluate the Referred Spine Surgeon
Prior to the first visit, a patient can start evaluating a particular spine surgeon by going to a spine surgeon's webpage (showing training, areas of specialty, practice philosophy, etc.) and to professional medical associations' websites that list information on spine surgeons who are members. We recommend that you look for surgeons who are board certified or board eligible and that focus on spine medicine (e.g., at least one-third to one-half of the surgeon's practice is devoted to spine medicine).
During the visit, patients will benefit from being prepared to truly interview their prospective spine surgeon. Find out the spine surgeon's own complication rate and success rate for the particular surgery. The surgeon should have data to share with potential new patients. Patients may also ask to speak with other patients who have gone through the same procedure with this surgeon. Other aspects to evaluate are found in Guidelines for Evaluating a Spine Surgeon. If a spine surgeon does not allow questions or acts disdainful of being questioned, consider interviewing another spine surgeon with whom you may be more comfortable. See also Red Flags to Notice When Choosing a Spine Surgeon.
Compare What You Hear with Reliable, Objective Information about Surgery
Comparing the surgeon's opinion and information to that published in reliable sources (such as physician-written, independent, peer reviewed sites on the Internet) can help a patient then determine if the treatment options are reasonable and better understand the advantages and disadvantages of each treatment option. You can compare your surgeon's specific answers with the general overview of the surgical procedure provided in the Back Surgery and Neck Surgery Overview.
Reaffirm Your Decision to Have Spine Surgery -- or Not
The decision about whether or not to undergo back surgery for chronic pain is almost always up to the patient. The spine surgeon should be able to give the patient enough information about the pros and cons of the procedure to help the patient decide. There are many highly effective surgical and non-surgical options to treat a variety of spinal conditions. But only you can decide if the particular procedure, with its scope, healing time, and expected rate of pain relief, and the particular spine surgeon are right for you. See also What to Expect from Spine Surgery for Low Back Pain.