- What should I bring when I come for my appointment?
- All recent x-rays, MRIs and CT scans – if you have a CD with your MRI on it, please bring it with you.
- A list of all medications you are currently taking
- Insurance information
- What should I expect during my appointment?
For your initial visit with us, you will fill out a form that includes information on your past medical history, medications, symptoms and previous treatments. If you have not had X-rays done of your neck or back, you may need to have these tests done before you see the doctor.
A medical assistant will escort you to the office and ask you a few questions about the reason for your visit. You will then see the doctor who will examine you, review your X-rays and MRI, and formulate a treatment plan for you.
- If I have back or neck surgery, is it likely that I will need more surgery in the future?
Fortunately we have reasonably good data to provide patients on the likelihood of needing future surgery. Your surgeon should be able to give you a rough idea of the percentage of patients who need more surgery in the future depending on the type of surgery that is being done and the location in the spine. For example, about 10% of patient who have a microdiscectomy in the lumbar spine have another herniation in the future. Such data is available for many other surgeries that are performed.
- My surgeon has recommended surgery, should I get a second opinion?
You have every right to obtain second opinions and if your surgeon does not encourage it (or worse, if he discourages it), it is a sign you should look for another surgeon. There are different techniques of approaching the same problem in the spine, and it is never a bad idea to seek other opinions.
- Should I see an orthopaedic surgeon or neurosurgeon?
The short answer is that it really depends on the surgeon, not the specialty. The field of spine surgery has evolved a lot over the last 3 decades and the two fields have merged to the point that there are now more similarities than differences between the two. Historically, orthopaedic surgeons have treated spinal deformities and performed fusions, whereas neurosurgeons have performed decompressions. However, over the last 3 decades, there has been increasing overlap and both orthopaedic and neurosurgeons now perform decompressions and fusions. Both subspecialists have undergone extensive training to safely perform spine surgery and your decision should rest more on your comfort and confidence in your surgeon rather than his/her speciality.
- Can laser surgery help my back pain?
Lasers do not play a role in spine surgery. Burning tissues in the spine risks injury to the nerves and is not recommended. Unfortunately this technology is aggressively advertised, but there is no evidence in the medical literature that it is effective. Patients often think that “lasers” are new technology, almost futuristic and are more effective than other techniques. This is false, as lasers play absolutely no role in spine surgery and are NOT endorsed by leading spine societies that advocate evidence based medicine. Burning tissue around nerves is dangerous, and it is far more efficient and safe to mechanically remove disc tissue with traditional instruments than with lasers.
Some centers use patient testimonials to support their practice. In medicine, this is the weakest form of evidence and should not be relied upon. Whenever a treatment is being evaluated for effectiveness in medicine, physicians rely on peer-reviewed publications. This means a surgeon writes an article describing his technique, the success rate of his technique and the complications associated with it. He then submits this article to a medical journal and a group of reviewers spend significant effort and time to judge the quality of the article and technique and the methods used to evaluate “success”. After a thorough vetting process, the article is either accepted or rejected by the journal’s editor. If a particular treatment has never been published through this vigorous process, it likely means that 1.) the treatment does not have merit, or 2.) the treatment is so new that there is not enough experience with it. In either case, it is irresponsible to aggressively advertise such a technique without any evidence to back it up. Unfortunately, this is the state of affairs when it comes to what is referred to as “laser spine surgery”. Remember the old adage: If it sounds too good to be true, it probably is.
- Does back surgery work?
The short answer is that it depends on why the surgery is being performed. Back surgery is very successful if performed in the appropriately selected patient. Patients often state that they know someone who has had back surgery and has not done well, so they assume they would have the same result. This is a mistake because every patient is different and there is a great range of spine pathology. Some back problems are successfully treated with surgery, and others are best treated nonsurgically. Your surgeon should give you an idea of the chances of success with surgery and then you can decide whether or not surgery is a good option for you.
- Will I need physical therapy after surgery?
In most cases, yes. After surgery, the muscles surrounding the surgical site get weak, and it is important to strengthen these muscles. Physical therapy usually starts 1-2 months after surgery. The exact timing of therapy and duration depends on the type of surgery that is done.
- I’m having back or neck surgery, does this mean my children will have the same problems
Not necessarily. Although arthritis in the spine does have a genetic link, most patients who have back or neck surgery do not have parents who have had similar issues.