When should I consider surgery?
Surgery is indicated when conservative therapy fails, the patient becomes dysfunctional and/or the patient is experiencing progressive neurological problems. Surgery is typically the last resort when it comes to treating spinal conditions in the neck or back. If various minimally invasive and non-operative treatments have been attempted without improvement and the patient’s condition worsens over time, then surgical treatment may be recommended. The decision for surgery should be individualized to the patient, the patient’s symptoms and the patient’s level of function.
Am I a candidate for minimally invasive spine surgery?
The field of minimally invasive spine surgery continues to grow and many surgeries are performed on an outpatient basis and often the hospital stay is one day or less. In addition, the surgical incision is often less than a two inches long. Often minimally invasive procedures result in a shorter hospital stay, reduced risk of infection and the faster recovery.
Certain conditions may require an in-patient/open procedure, such as a severe scoliosis, spinal tumors and some infections. Your surgeon will review all procedure options with you.
Do I need an MRI, CAT Scan and/or an x-ray before I have a consultation and/or surgery?
Diagnostic testing is required to assist in the diagnosis and evaluation process. In addition, recent diagnostics assist in determining the surgical plan. The surgical team will explain what testing is required.
Note: It is important for patients to have the most recent MRI, CAT Scan and/or x-rays on a CD allowing for review by the surgeon during the consultation process. If the patient does not have recent imaging, arrangements can be made to schedule imaging and a neurosurgical consult on the same day.
Do I need to stop taking any medications prior to surgery?
There are many medications, both prescription and over-the-counter, which can increase your chance of bleeding. Because of these effects, there are requirements that certain medications be held prior to surgery. As an example, you must be off all aspirin or anti-inflammatory drugs (or any combinations drugs that contain these ingredients).
When scheduling your surgery, please provide a list of all of the medications you are taking. Our team will review this list and we may need to consult with your family physician or a specialist should there be any questions.
How long will I be in the hospital?
Minimally invasive spine surgery decreases time spent in the hospital and typically decreases recovery time. In some instances recovery time and hospital stays are cut in half! Many patients go home shortly after surgery on the same day. For various types of lumbar fusion surgery, the patient often goes home within two to three days.
If travelling from out of town, how long will I have to stay in the area?
Upon scheduling your surgery, we will discuss this with you as this will be dependent on the distance and means of travel and the individual patient. Also, the travel timing will be dependent on whether a minimally invasive or fusion surgery was performed. Please note that we have negotiated special hotel rates for our International patients and we assist in making your arrangements as needed.
When can I go back to work after back surgery?
The decision to return to work is individualized to the patient. The patient’s lifestyle and occupation will certainly contribute to this decision. In certain circumstances, the patient may be able to go back to work within two to three weeks if the patient has a sedentary job. For those with active lifestyles or those in a field where bending and lifting are required, the return to work date may be six to eight weeks after surgery or even longer.
When can I start resuming activities?
Most patients are able to get up out of bed and start walking shortly after surgery, usually on the same day. For the first six to eight weeks, the activity level may be limited to walking and restrictions in daily activities. Patients are encouraged to avoid heavy lifting, frequent bending, twisting, turning or climbing during the first six-week period. The patient’s progress will be monitored closely during the post-op process to determine appropriate post-op care. Physical therapy is an important component of a rapid recovery. A physical therapy regime is individualized to the patient, but in most cases, physical therapy is enacted two to six weeks after surgery, depending on the surgery performed and the patient’s overall condition.
Will I have to take pain medication after my surgery? Will I become dependent?
Often pain medications are prescribed just for the initial period immediately following surgery. There is no evidence that post-operation pain treatment leads to addiction.
Do I have to wear a brace?
In most instances it is recommended that patients wear a brace following surgery. A brace fitting will take place prior to surgery and instructions for the brace will be provided both during the pre-operative and post-operative period.
Will I need physical therapy after surgery?
Physical therapy is an important component of recovery and rehabilitation. This is individualized to the patient, but in most cases, physical therapy is started two to six weeks after surgery, depending on the surgery performed and the patient’s overall condition. Your post-operative physical therapy regime should concentrate on stretching, core strengthening, sitting/standing positions and with activities which correspond with lifestyle and work requirements.
Is minimally invasive spine surgery experimental?
Minimally invasive surgery has been used successfully for many, many years. The scope of procedures performed and the equipment and technology available to our surgeons changes rapidly. Our surgeons utilize the latest equipment and techniques in hopes of shortening recovery time and improving quality of life with the least invasive means possible.
Will I have irreversible damage if I delay surgery?
Your physician will advise you of the risks associated with a delay in surgery. In general, if there is severe spinal cord compression or a nerve is compressed over a period of time, there may be irreversible damage. If a patient experiences an increase in weakness, loss of balance, or loss of bladder or bowel control, consult with a spine specialist immediately as these are signs that your condition may be worsening.
When do I need a fusion?
Treatment plans are individualized for each patient. A fusion becomes necessary when there is instability in the spine. This may occur because of degeneration of the disc, a spinal deformity such as spondylosis, or as a result of removing a disc during surgery. A fusion is performed to reconstruct the spine’s natural balance and curvature. Instrumentation such as screws and plates may be used to stabilize the spine.
Why is surgery often performed through the front of the neck?
The anterior (front) approach may be preferred by your surgeon because the muscles in the front of the neck naturally part and offer direct access to the disc while the spinal cord is protected by the vertebra. Because the muscles naturally part rather than being cut, there is often less trauma and a faster recovery.
What are my chances for success?
The success of the surgery is determined by the reconstruction of the balance of the spine and the reduction/elimination of the patient’s symptoms. The outcome is dependent on the condition of the spine, the surgeon performing the surgery and the patient’s ability to follow medical recommendations.
What are the risks associated with surgery?
There are risks associated with any surgical procedure. Risks will be explained during the surgery consultation and consenting process.