The news that you may need spinal surgery can cause many emotions: hope that you may find more pain relief, fear about the procedure and recovery, and confusion about what to do next. Before you make a decision, take steps to empower yourself by learning everything you can about your condition, the treatment options, and your surgeon.
Know the cause of your pain
Identifying the cause of your pain is different than 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.
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. To learn more, see 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 perfect way to evaluate and compare surgeon competencies, your physician will likely have to use word of mouth and anecdotal data.
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 if he or she let the spine surgeon do surgery on one of his or her own family members.
Be well prepared for your medical consultation
When you're in pain, it can be difficult to describe your situation to your doctor in a complete, concise, and accurate manner. Meeting a spine surgeon can also be overwhelming and intimidating. 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 (which should list 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 who focus on spine medicine (e.g., at least 1/3 to 1/2 of the surgeon's practice is devoted to spine medicine).
During your visit, be prepared to interview your 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. You may also ask to speak with other patients who have gone through the same procedure with this surgeon.
If a spine surgeon does not allow questions or acts disdainful of being questioned, consider interviewing another surgeon with whom you may be more comfortable.
Do your research
Comparing the surgeon's opinion and information to what has been published in reliable sources (such as physician-written, independent, peer-reviewed sites on the Internet) can help you 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. Your surgeon should be able to give you enough information about the pros and cons of the procedure to help you 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.