10 Fears You May Have about Spine Surgery (and What to Do about It)

1. Pain That Doesn’t Improve — or Gets Worse

Many people worry that surgery could fail to relieve their pain, or that the pain could become even worse. This includes concern about persistent nerve pain or discomfort that lasts long-term.

There are many reasons this could occur, and it is common enough that there is a term for it – Failed back surgery syndrome.

2. Complications After the Surgery

Even if the surgery seems to go well, it is rare but possible for any type of device used to dislodge or migrate, for example:

• the screws used in a lumbar fusion could shift or dislodge
• a cervical artificial disc could slip out of place
• the plate and/or screws used in an ACDF could become loose or shift
• the paddle and/or leads used in spinal cord stimulation could migrate out of place

While relatively rare, any of these types of issues could lead to potentially serious complications and possibly the need for additional surgery.

3. Loss of Mobility or Flexibility

With spinal fusion in particular, a possible concern is that a fused spinal segment will reduce their ability to bend, twist, or move comfortably, especially if multiple spinal levels were fused.

4. Permanent Life Changes or Disability

It is a valid concern for some people that a spine surgery could permanently alter their lifestyle — limiting their ability to work in their chosen field, exercise, travel, or be active with their children and grandchildren.

5. Fear of Major Surgery and Anesthesia

Undergoing a long operation and general anesthesia causes significant anxiety for many people, such as the fear of “being under” and not knowing how you’ll feel when you wake up.

6. Surgical Complications

Concerns include nerve injury, infection, blood loss, hardware failure, scarring, or ongoing nerve symptoms after surgery. These concerns become more significant if you have other health conditions, such as diabetes or cardiovascular problems, and if it is a major spine surgery.

7. A Long and Challenging Recovery

This concern applies more so for major surgeries like lumbar fusion or multilevel spine surgery. Recovery for major spine surgery typically involves months of activity restrictions, physical therapy, and gradual return to function.

8. The Risk of Paralysis

Because the surgery involves the spine, many people worry about the risk of paralysis. they won’t be able to return to their previous level of work, household activities, hobbies, or exercise — even if the surgery is technically successful.

9. Degeneration Above or Below the Fusion

For spine fusion surgery specifically, there is a risk the spinal levels above or below the fused segment will wear out over time, potentially causing new pain or the need for another surgery.

There is a term for this, it’s called Adjacent Segment Disease.

10. Uncertainty About Making the Right Decision

A major underlying fear is simply not knowing whether surgery is the right choice — and worrying about regret if outcomes don’t match expectations.

Major Spine Surgery vs. Minimally Invasive

The above concerns are most strongly associated with major spine surgeries, particularly lumbar fusion procedures, which permanently alter spinal mechanics and involve longer recoveries.

There are many other types of spine procedures, such as endoscopic approaches, decompression-only (e.g. laminectomy), and minimally invasive or less invasive surgery (e.g. microdiscectomy or ACDF), or spinal cord stimulation, that typically involve:

• less tissue disruption
• smaller incisions
• shorter recovery times

While these procedures still raise concerns, they tend to generate less fear overall than large reconstructive surgeries such as fusion.

How to Address These Very Real Concerns

If you’re considering spine surgery, take the steps you need to make a more confident, informed decision:

• Research your specific diagnosis
  • Focus on information that applies to your exact condition, spinal level, and symptom pattern, not just spine surgery in general.
• Get a second (or third) opinion
  • Independent opinions can confirm whether surgery is truly indicated — and whether fusion is necessary or if alternatives exist.
  • Consider getting an opinion from a nonsurgical spine specialist, like a physiatrist
• Make a wholehearted effort with nonsurgical treatments
  • There may be more nonsurgical options than you’ve tried, such as appropriate types of physical therapy, activity modification, medications, anti-inflammatory protocols, injections, nerve ablation, and more.
• Understand the goal of surgery
  • Understand what the goal of the surgery is so you’re expectations are reasonable – e.g. less pain, nerve protection, stability, function - not necessarily being “pain-free.”
• Use reliable, non-commercial education sources
  • Seek balanced, evidence-based information from trusted resources such as Spine-health.com, which focuses on patient education rather than doing surgery.

Bottom line:

Concerns about spine surgery are healthy and valid.

You’re started your research by reading this – and you think it’ll help, print up this list of 40 questions to ask your surgeon, identify which ones apply to you and bring it to your next doctor appointment to discuss.