Top Ten Questions on Spinal Disorders and Spinal Surgery
What sets the Center for Spinal Disorders apart?
We believe that every person is entitled to an individualized approach. Your spine is not a cookie cutter, nor is your spinal pathology. And therefore, we take the time to listen to you, to accurately diagnose, to view your studies, and to come up with a plan which is made for you and not for someone else. That is probably the most important aspect of any medical or surgical procedure, and certainly when it relates to spinal surgery.
Do most spinal conditions need surgery?
Absolutely not. The majority of spinal conditions are lumbar sprains and strains, cervical sprains and strains and mild disc herniations which can be managed with a combination of conservative modalities such as physical therapy, anti-inflammatory medications, mild narcotic medications, and at times, injections. Modalities such as chiropractic and acupuncture also play an important role. In instances when these conservative modalities fail, then a patient can be considered for spinal surgery. In a very, very small instance of cases, spinal surgery is emergent but that is very rare.
Can my surgery be done minimally invasively?
Over the last 20 years, spinal surgery has gone from a maximal conditional invasive approach to a more minimally invasive approach. At the Center for Spinal Disorders, we are committed towards maintaining a cutting-edge knowledge of this new technology. However, each case has to be evaluated on an individualized basis. Your case may be amenable to a minimally invasive spinal surgery. Within minimally invasive spinal surgery there are various categories. It is important to be well-examined by your physician, including the x-ray, CT scan and/or MRI studies and then an appropriate plan. Approximately 10 – 20% of the time, spinal pathologies and spinal surgeries can be done through a minimally invasive or a hybrid minimally invasive approach.
How much time will I need to be out of work?
That depends. If surgery is done on a minimally invasive level, the answer is perhaps only a day or two. However, even in those settings, it is a good idea to try and allot some time off; perhaps a week to 10 days. In other instances, in which there is fusions and/or osteotomies which need to be done, the time off from work will be much more extensive, perhaps in the range of 2 – 6 weeks and sometimes beyond. Again, each case is different
and no two spinal situations are alike.
Can my discs be replaced?
Yes. Over the last 10 – 12 years, more and more lumbar and cervical discs have been replaced. However, depending on the pathology, a disc replacement may be too aggressive a procedure for your given case. Discuss the issue of disc replacement with your surgeon.
If surgery is necessary, what should I look for in a doctor?
Be sure that the doctor that you choose to perform your spinal surgery has taken his time to fully examine you, fully evaluate your studies, and fully describe to you the procedure and/or risks and complications. If he or she is unable to do so to your liking, think twice about that doctor.
Second of all, the best results are in the settings of a team approach where the spinal surgeon, the spinal assistant, as well as the spinal anesthesiologist have done the procedure before, are comfortable with each other, and are comfortable with the setting of the operation.
Can the surgery be done in a hospital or an ambulatory surgery center?
It depends on the case. Some of the more minimally invasive procedures can be safely done in an ambulatory surgery center. Even those surgeries which are slightly more complex, such as a one-level cervical disc replacement or fusion or a lumbar disc replacement or fusion, can often be done in an ambulatory surgery center with the patient going home within 6 – 23 hours. Patients with comorbidities and/or for longer procedures are more safely done in a hospital setting. Be wary of physicians or practices which are steering you to have a surgery done in a particular setting, when you are uncomfortable with it.
If I have a spinal surgery, what are the chances of me needing additional surgery at a later date?
Excellent question. Overall, it can be said that there is approximately a 5 – 15% chance of the necessity for revision or additional surgery in the spinal setting. That additional surgery may be at the level which was operated on, because of further degeneration or collapse, or at an additional level, either above or below the surgery. This means that we have to think very carefully about choosing the spinal surgery which we undergo, choosing the levels, as well as choosing the physician to perform the operation.
I have heard so many bad things about spinal surgery. How can I feel confident in proceeding with a procedure even though I am in pain?
Spinal surgery has gotten a bad rap over the last 10 – 15 years. Although it is true there is the potential for major complications, the most feared and dread complication- i.e., that of paralysis, is the rarest and most unlikely to actually take place. Very often, friends and/or relatives are giving opinions which are based very little on fact. As often as we hear that a patient has been told that they could end up paralyzed, it is very rare to actually find someone who suffers from this dreaded complication from the resultof a routine spinal surgery.
Is spinal surgery dangerous?
All surgery has inherent risks. Certainly, spinal surgery has its own set of risks which may include infection, pain at the incision site, lack of fusion, as well as neurologic complications. However, with well-trained hands, the incidence of complications differs very little than from other surgical conditions. It is important to discuss with your doctor what he feels the overall chances of a particular complication are in your given setting.