What questions should you ask before back surgery?

If you’ve been living with back pain and a physician has recommended surgery, how do you know if undergoing surgery is the most appropriate treatment? Start gathering the information you need to make an informed decision by asking your physician these key questions.

• Are there non-surgical treatments that I could try first? For some types of back pain, physical therapy, anti-inflammatory medications, steroid injections, weight loss and exercise, the application of heat and/or cold therapy, and therapeutic massage may provide relief. In most cases, your physician should recommend surgery after you’ve tried and failed to get sustained relief and improved function from all appropriate non-surgical treatment options.

• What procedure are you recommending and why? Find out which type of surgery your physician wants to perform and have him or her explain what the surgery entails, for example will a disc be removed, will screws or other hardware be implanted, will a bone graft be required? Ask how long the surgery takes and what you can expect as part of the recovery process. It’s also important to find out what the potential risks and benefits of the procedure are. You should ask why this type of surgery is being recommended. Is the goal pain relief, improved function and the ability to take part in physical activity, or to correct an anatomical problem?

• How long will the benefits of the surgery last? You want to know whether any positive results of the procedure are expected to resolve the problem permanently or if you will need another surgery in the future to maintain the result. You should also find out if the surgery could increase the likelihood of other types of back problems, such as degenerated discs or arthritis, in the future.

• How frequently do you perform this surgery and what are your success and complication rates for this procedure? Finding an experienced surgeon and a hospital where a larger volume of the type of surgery that’s been recommended is performed are important factors in choosing the right specialist and medical center. The physician you choose should have a high level of experience with the specific surgery and preferably should be fellowship-trained in spine surgery. Also, those surgeons performing minimally invasive surgery should specific training and experience.

• Where will the surgery be performed? In the past, most spine surgeries were performed as inpatient procedures in the hospital. There are a number of surgeries, however, that can now be performed on an outpatient basis or at an ambulatory surgery center. Ask how frequently this type of surgery is performed on an outpatient basis, how the results compare with the same procedure performed in the hospital, and why the surgeon is recommending outpatient versus inpatient surgery. Find out the success and complication rates for the hospital or surgical center where your procedure will be performed.

• What type of anesthesia will be used during surgery? Depending on the type of surgery, you could receive local, regional or general anesthesia. Find out which type will be used, who will be administering the anesthesia and how experienced that person is with the specific type of anesthesia. Ask about possible side effects and risks.

Before scheduling any surgery, you should seek a second opinion to confirm your diagnosis and the proposed treatment plan. Your surgeon will most likely welcome your decision to seek a second opinion, but if he or she does not, you should choose another physician.