Questions to ask your surgeon about spinal surgery

What to ask your surgeon about spinal surgery - before; Before spinal surgery - surgeon questions; Before spinal surgery - what to ask your surgeon; Questions to ask your surgeon about back surgery

You are going to have surgery on your spine. The main types of spinal surgery include diskectomy, laminectomy, foraminotomy, and spinal fusion.

Below are questions you may want to ask your surgeon to help you prepare for spinal surgery.

Questions

How do I know if spine surgery will help me?

What is the cause of my symptoms?
Why is this type of surgery recommended?
Are there different methods for doing this surgery?
How will this surgery help my spinal condition?
Is there any harm in waiting?
Am I too young or too old for spinal surgery?
What else can be done to relieve my symptoms besides surgery?
Will my condition become worse if I do not have the surgery?
What are the risks of the operation?

How much will spine surgery cost?

How do I find out if my insurance will pay for spine surgery?
Does insurance cover all of the costs or just some of them?
Does it make a difference which hospital I go to? Do I have a choice of where to have surgery?

Is there anything that I can do before the surgery so it will be more successful for me?

Are there exercises I should do to make my muscles stronger?
Do I need to lose weight before surgery?
Where can I get help quitting cigarettes or not drinking alcohol, if I need to?
Quitting cigarettes
There are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...
Image

Read Article Now Book Mark Article
Not drinking alcohol
This article describes how to determine if you have a problem with alcohol use and offers advice on how to decide to quit drinking.

Read Article Now Book Mark Article

How can I get my home ready before I go to the hospital?

How much help will I need when I come home? Will I be able to get out of bed?
How can I make my home safer for me?
Home safer
Getting your home ready after you have been in the hospital often requires much preparation. Set up your home to make your life easier and safer when...

Read Article Now Book Mark Article
How can I make my home so it is easier to get around and do things?
How can I make it easier for myself in the bathroom and shower?
What type of supplies will I need when I get home?

What are the risks or complications of the spine surgery?

What are the risks and complications of the surgery?
What can I do before surgery to make the risks lower?
Do I need to stop taking any medicines before my surgery?
Will I need a blood transfusion during or after the surgery? Are there ways of saving my own blood before the surgery so it can be used during the surgery?
Saving my own blood
Your surgeon will be very careful during surgery to limit the amount of blood you lose. But blood may continue to ooze from tissues that were cut, e...

Read Article Now Book Mark Article
What is the risk of infection from surgery?

What should I do the night before my surgery?

When do I need to stop eating or drinking?
Do I need to use a special soap when I bathe or shower?
What medicines should I take the day of surgery?
What should I bring with me to the hospital?

What will the surgery be like?

What steps will be involved in this surgery?
How long will the surgery last?
What type of anesthesia will be used? Are there choices to consider?
Will I have a tube connected to my bladder? If yes, how long does it normally stay in?

What will my stay in the hospital be like?

Will I be in a lot of pain after surgery? What will be done to relieve the pain?
How soon will I be getting up and moving around?
How long will I stay in the hospital?
Will I be able to go home after being in the hospital, or will I need to go to a rehabilitation facility to recover more?

How long will it take to recover from spine surgery?

How should I manage the side effects such as swelling, soreness, and pain after the surgery?
How will I care for the wound and sutures at home?
Are there any restrictions post-surgery?
Do I need to wear any kind of brace after spine surgery?
How long will it take for my back to heal after the surgery?
How will spine surgery affect my work and routine activities?
How long will I need to be off work after the surgery?
When will I be able to resume my routine activities on my own?
When can I resume my medicines? How long should I not take anti-inflammatory medications?

How will I gain my strength back after the spine surgery?

Do I need to proceed with a rehabilitation program or physical therapy after the surgery? How long will the program last?
What type of exercises will be included in this program?
Will I be able to perform any exercises on my own after the surgery?

Open References

References

Li Y, Ling MZ, Wang MY. Perioperative management protocols: Enhanced recovery after surgery. In: Steinmetz MP, Berven SH, Benzel EC, eds. Benzel's Spine Surgery. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 79.

Stefanelli AJ, Sabourin V, Hines K, Singh H, Harrop JS. Fundamentals of spine surgery. In: Steinmetz MP, Berven SH, Benzel EC, eds. Benzel's Spine Surgery. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 78.

Herniated nucleus pulposus - illustration
Herniated nucleus pulposus is a condition in which part or all of the soft, gelatinous central portion of an intervertebral disk is forced through a weakened part of the disk, resulting in back pain and nerve root irritation.
Herniated nucleus pulposus
illustration
Lumbar spinal surgery - Series
Presentation

<strong>Lumbar spinal surgery - Series</strong><p>The spine is made of bones (vertebrae) separated by soft cushions (intervertebral disks).</p>

<strong>Indications</strong><p>Lumbar (lower back) spine disease is usually caused by herniated intervertebral disks; abnormal growth of bony processes on the vertebral bodies (osteophytes), which compress spinal nerves; trauma; and narrowing (stenosis) of the spinal column around the spinal cord. Symptoms of lumbar spine problems include pain that extends (radiates) from the back to the buttocks or pain in the back of the thigh that interferes with daily activities; weakness of legs or feet; numbness of legs, feet, or toes; or a loss of bowel of bladder control.</p>

<strong>Incision</strong><p>The surgery is done while the patient is deep asleep and pain-free (general anesthesia). An incision is made over the lower back, in the midline.</p>

<strong>Procedure</strong><p>The bone that curves around and covers the spinal cord (lamina) is removed (laminectomy) and the tissue that is causing pressure on the nerve or spinal cord is removed. The hole through which the nerve passes can be enlarged to prevent further pressure on the nerve. Sometimes, a piece of bone (bone graft), interbody cages, or pedicle screws may be used to strengthen the area of surgery.</p>

<strong>Aftercare</strong><p>Patients usually require physical therapy to optimize spinal mobility after lumbar spine surgery. Results are variable depending on the disease treated.</p>

Spinal surgery - cervical - series
Presentation

<strong>Spinal surgery - cervical - series</strong><p>The cervical spinal column is made up of vertebral bodies which protect the spinal cord.</p>

<strong>Indications</strong><p>Cervical spine disease is usually caused by herniated intervertebral discs, abnormal growth of bony processes on the vertebral bodies (osteophytes), which compress spinal nerves, trauma, and narrowing (stenosis) of the spinal column around the spinal cord. Symptoms of cervical spine problems include; Pain that interferes with daily activities; Neck pain that extends (radiates) to the shoulder or arm; Weakness of arms or legs; Numbness of arms, hands, or fingers.</p>

<strong>Incision</strong><p>The surgery is done while the patient is deep asleep and pain-free (general anesthesia). For the neck (cervical spine), an incision may be made either in the back of the neck (posterior cervical) or in the front side of the neck (anterior cervical), depending on the location of the problem.</p>

<strong>Aftercare</strong><p>Depending on the disease present and the surgery performed, mobility of the cervical spine may be limited after cervical spine surgery. Physical therapy is often indicated after surgery.</p>

Microdiskectomy - series
Presentation

<strong>Microdiskectomy - series</strong><p>The appearance of a normal intervertebral disk is compared to a herniated disk.</p>

<strong>Microdiskectomy - Incision</strong><p>A small incicion is made over the spine. </p>

<strong>Microdiskectomy - Indications</strong><p>After identifying and moving the nerve root, the surgeon identifies the injured disk tissue.</p>

<strong>Microdiscectomy - Procedure</strong><p>The surgeon removes the injured disk tissue and fragments.</p>

<strong>Microdiskectomy - Aftercare</strong><p>The back muscles are moved back into their normal position, and the wound is closed with stitches or staples.</p>

Spinal stenosis - illustration
Spinal stenosis is a narrowing of the lumbar or cervical spinal canal. The narrowing can cause compression on nerve roots resulting in pain or weakness of the legs. Medications or steroid injections are often administered to reduce inflammation. If the pain is persistent and does not respond to these conservative measures, surgery is considered to relieve the pressure on the nerves.
Spinal stenosis
illustration
Spinal fusion - series - Normal anatomy
Presentation

<strong>Spinal fusion - series - Normal anatomy</strong><p>The vertebrae are the bones that make up the spinal column, which surrounds and protects the spinal cord. The intervertbral discs are soft tissues that sit between each vertebrae and act as cusions between vertebrae, and absorb energy while the spinal column flexes, extends, and twists. Nerves from the spinal cord exit the spinal column between each vertebra.</p>

<strong>Indications</strong><p>Spinal fusion is a surgical technique in which one or more vertebrae are fused together to stop the motion between them. Spinal fusion may be recommended for abnormal curvature of the spine (scoliosis or kyphosis); injury to the spinal vertebrae; protrusion of the cushioning disk between vertebrae (slipped disk, herniated nucleus pulposus); or a weak or unstable spine caused by infections or tumors.</p>

<strong>Incision</strong><p>Different incisions are made depending on the area to be treated. The approach can be made either from the front (anterior), from the back (posterior), or both.</p>

<strong>Procedure - Posterolateral gutter fusion</strong><p>In a posterolateral gutter fusion procedure, the spine is approached from the back. Bone graft is taken from the pelvis and laid out in the posterolateral portion of the spine that is to be fused. The back muscles hold the graft in place until it fuses with the vertebrae. A fusion will setup within three months and will continue to get stronger for one to two years.</p>

<strong>Interbody cage fusion</strong><p>Interbody cage fusion uses a hollow threaded titanium or carbon fiber cylinder to fuse two vertebrae together. The diseased disk is removed and two interbody cages are placed in the opening where the diseased disk has been removed. The cages are filled with bone graft. The bone grows through the holes in the cages fusing the vertebrae.</p>

<strong>Pedicle screw</strong><p>Pedicle screws are used sometimes in a spinal fusion to add extra support and strength to the fusion while it heals. Pedicle screws are placed above and below the vertebrae that were fused. A rod is used to connect the screws which prevents movement and allows the bone graft to heal. After the fusion is completely healed, the screws and rods can be removed. Removal isn't necessary unless they cause the patient discomfort.</p>

Herniated nucleus pulposus - illustration
Herniated nucleus pulposus is a condition in which part or all of the soft, gelatinous central portion of an intervertebral disk is forced through a weakened part of the disk, resulting in back pain and nerve root irritation.
Herniated nucleus pulposus
illustration
Lumbar spinal surgery - Series
Presentation

Spinal surgery - cervical - series
Presentation

Microdiskectomy - series
Presentation

Spinal stenosis - illustration
Spinal stenosis is a narrowing of the lumbar or cervical spinal canal. The narrowing can cause compression on nerve roots resulting in pain or weakness of the legs. Medications or steroid injections are often administered to reduce inflammation. If the pain is persistent and does not respond to these conservative measures, surgery is considered to relieve the pressure on the nerves.
Spinal stenosis
illustration
Spinal fusion - series - Normal anatomy
Presentation

A Closer Look

Talking to your MD

Questions to ask your surgeon about spinal surgery

Self Care

Tests for Questions to ask your surgeon about spinal surgery

Review Date: 10/15/2023

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Health Library

Questions to ask your surgeon about spinal surgery

Diskectomy

Laminectomy

Foraminotomy

Spinal fusion

Questions

Quitting cigarettes

Not drinking alcohol

Home safer