5 Questions to Ask Your Spine Surgeon Who Has Recommended Surgery
Depending on how long you live with chronic back pain, or how severe it becomes over time, your surgeon may recommend surgery. If he or she does, here are some questions you can ask to learn more about how he or she came to their decision.
What are the alternatives to surgery?
In the health care field, all of us want to think our specialty is going to offer the best treatment for the patients we are treating because we want to help – physical therapists, chiropractors, regenerative therapy providers, or surgeons. It's especially important for patients to see more than one provider when a surgeon says the only answer is surgery. An operation is the answer for many patients, but we all have an inherent conflict of interest because we want to be the one to fix the problem. All providers need to be as aware as possible of our subconscious bias that our specialty is the only answer.
What will happen if I don’t have an operation?
Your surgeon should discuss three things: risks, benefits, and alternatives to surgery. Many injuries get better with time, and some degenerative processes may become less bothersome. In some cases, waiting for an operation can place you at greater risk for long-term problems. But for most people, the “tincture of time” can help give them a better perspective on the problem.
If your surgeon has offered a spinal fusion, ask why a fusion would be necessary.
A spinal fusion of two or more vertebrae is often necessary to stabilize a spine that is too mobile or crooked. For many patients, a fusion may only make your recovery more involved and carry a greater risk. Ask if the same operation can be performed without a fusion.
Would you recommend the same operation to your family member?
This question may seem silly, but it always makes me pause and think. I consider my siblings, my parents, and my good friends going through the same thing. You are more than an X-ray and MRI: your surgeon should know you well enough to be able to make the decision with you if surgery is your best option.
Should I have a second opinion?
You already know the answer to this question: yes. The surgeon who discourages you from seeking out more information or another set of eyes for your problem is not giving you good advice. I’ve heard other surgeons say: “If you want a second opinion, you can ask me twice!” Medicine is as much an art as it is a science, and there is often an alternative operation (or no operation) to your problem. It’s important to seek out another opinion for your condition, if nothing else but to confirm what you already know. Use this question as a litmus test for if your surgeon is looking out for your best interest.
Research your health before and after your office visit
Do the research on your problem, and seek out a surgeon that you feel comfortable with, especially in the office. Knowing a little information about your condition will help you get the most out of your visit. If you have access to them, review the MRI reports or your other doctor’s referral note. Ask if your doctor is comfortable if you record the interview; a lot of information can be given to you in a brief visit. After your visit, request the note from your office visit – this will help you review the information you just discussed.
Choosing your surgeon
When choosing your surgeon, you’re trusting that professional to make decisions that are in your best interest. It’s important to consider your surgeon’s ability, availability, and trustworthiness when moving forward with surgery:
- Ability: There are often many solutions to a single medical or spine problem. For example, a spine surgeon who has not trained in motion-preserving techniques may only recommend a fusion procedure, simply because he or she isn't able to offer another treatment. Similarly, a surgeon who has only trained with "open" surgery may recommend against a minimally invasive one, and vice versa. You should feel comfortable asking: "Is my surgeon able to perform the procedure that I need, or just the one that he or she is comfortable offering me?"
- Availability: A good medical team will be available both before and after your operation. It is important to ask: "Is my surgeon able to answer my questions, and will he or she be available after my surgery?"
- Trust: Asking someone to provide your medical care necessarily involves a great degree of trust. At some point, you will place your trust in your surgeon to do what is in your best interest when you are under anesthesia. For any provider, and especially your surgeon, it is important to ask: "Do I trust him or her to do what is in my best interest at all times?"
Joseph Morreale, MD
MountainView Spine Center