From alternatives to spinal fusion to surgical outcomes and expectations, here are some of the most common questions patients ask spine surgeons Gurvinder Deol, MD, and Issada Thongtrangan, MD. The spine surgeons also discuss the importance of educating patients before surgery.
Note: Responses are lightly edited for style and clarity.
Question: What is the No. 1 question spine patients ask you today?
Gurvinder Deol, MD. Wake Orthopaedics (Raleigh, N.C.): The No. 1 question surgical spine patients ask is how long they will be in the hospital or how long they will 'be down' after having spine surgery.
It is still surprising to me that so many people still associate spinal surgery with extended hospital stays and very lengthy recoveries. It is imperative that we continue to educate patients in our ability to execute successful, safe outpatient surgery, whether motion-sparing or fusion, and return them to work or the activities they enjoy expeditiously.
Issada Thongtrangan, MD. Microspine (Scottsdale, Ariz.): One of the most common questions is around spinal fusion. My patients often ask me what I can offer them except fusion.
I spend a good amount of time educating them on how I can offer a 'nondestructive' motion-preservation spine surgery using a minimally invasive approach. Most patients do not need fusion. There are several alternatives, and the majority of them even have level I evidence showing excellent outcomes — for example, disc replacement, interlaminar stabilization, endoscopic spine surgery, etc.
Nowadays, these surgeries can be done outpatient with minimal downtime if they are good candidates. I show patients the spine model and video clips so they understand their conditions and how I can help them. I also spend time educating them about expectations and outcomes.
Fusion surgery still has a major role in deformity, fracture, instability, tumor and some failed back surgery. I explain to them that the technologies are far more advanced and that the surgery can be done in a less disruptive fashion using several tools, including a tubular retractor, microscope, endoscope and navigation.
Education is the key. I never minimize their fears or concerns about having spine surgery.