Spine surgery is often practiced by Neuro and Orthopedic surgeons. Within these respective fields there are other subspecialties - for example a Neurosurgeon who performs spinal surgery can also have a practice which includes brain surgery for tumors, aneurysms, etc. and an Orthopedics surgeon who performs spinal surgery can also have a practice which includes fracture care, joint replacement and more. Due to complexities of spinal surgery, it is advisable to see a surgeon whose practice is focused solely on spinal surgery.
Since minimal invasive surgery allows for faster recovery and a quicker return to normal activities, it is slowly becoming the standard of care for most spinal surgeries, especially for degenerate spine disease.
It is preferable to see a spinal surgeon who practices minimal invasive surgery for the reasons stated above.
4. What is your complication rate?
Unfortunately, complications are a potential byproduct of any surgical procedure and even the very best surgeon will have complications. However, in asking this question, the patient can get a feel as to whether the surgeon has an inordinate amount of complications, generally seen as anything over 10%.
The infection rate for a spinal surgeon should be 10% or less. A surgeon with a higher rate than this does not necessarily mean that the surgeon has poor surgical skills, but instead could just be performing more complicated cases or operating on patients with higher risk factors for infections (i.e. diabetes, older patients, vascular disease, smoking, etc.). However, if the surgeon has a higher rate, patients should ask for an explanation.
Non-surgical treatment - including therapy, medications and injections - is the mainstay for most spinal conditions, including back and neck pain and even radiating nerve pain to an extremity. Surgery should only be considered if the patient develops weakness in an extremity or if the spinal cord itself is at risk.
The recovery time for a spinal surgery is influenced by many factors - the patient's overall health, the seriousness of the conditions and the length and seriousness of the surgery. Surgeons should always be able to give an estimated timeframe when a patient can resume regular activities.
The surgeon should be able to explain the diagnosis and all available treatment options. Depending on the ailment, some options are obviously better for certain disorders. For example, physical therapy and medications are reasonable options for mechanical back pain, but are not the best options for a patient who presents with a large cervical disc herniation or upper extremity weakness.
The diagnosis, the treatment options and the alternatives should always be clearly laid out for the patient. Included in these alternatives is the option of not having surgery, even if that is not recommended. If surgery is warranted for a particular condition and the patient chooses not to proceed, then the likely results of not having surgery should be explained in detail. In the case of back pain, the likelihood is that the symptoms might stabilize or progress, but usually most patients can adjust their lifestyle to these symptoms. However, in the case of weakness in an extremity, it is unlikely that the symptoms will improve.
A second opinion is a good idea when contemplating spinal surgery. This allows patients a fresh perspective on their condition and treatment. Upon request, the doctor should be able to help facilitate the process in getting a second opinion.
About Dwight S. Tyndall, M.D., FAAOS
Dr. Dwight Tyndall is a leading spine care specialist concentrating in minimally invasive spine surgery and all aspects of spine care. After completing a Spine Surgery Fellowship at the world-renowned Hospital for Special Surgery at Cornell University Medical Center, Dr. Tyndall opened a private practice in the Midwest dedicated to providing patients with personalized care and the most advanced spine care technology available. Among his accomplishments, Dr. Tyndall performed the first Medtronic's BRYAN® Cervical Disc replacement in Northwest Indiana. With a consortium of fellow minded surgeons, Dr. Tyndall recently opened a state-of-the-art facility devoted to minimal invasive surgery in the Midwest where he works with patients from Northwest Indiana, Chicago and various parts of the country.
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