Spinal surgery patients face big decisions: which procedure, which doctor?

Jul 20 2011
The decision to undergo a spine surgery can be a difficult one, but sometimes it is the only way to ease persistent low back pain after conservative treatments have failed.

Still, there are many important factors that a patient needs to take into consideration before selecting which procedure to undergo and where to do so.

The former issue is one that is obviously done in consultation with a healthcare provider. Depending on the type of care the patient is getting, this can involve their primary care physician and an orthopaedic surgeon, or just the latter.

Selecting the best surgery option is based chiefly on the patient's condition, age and sometimes his or her insurance status. For conditions such as degenerative disc disease, the traditional mode of surgical treatment is open-back surgery such as spinal fusion.

However, this type of intervention involves extensive recovery time due to soft tissue trauma, reduced mobility caused by the loss of spinal flexibility and high costs that stem from the expense of artificial implants and an extended hospital stay. For this reason, some people many also find it hard to receive insurance reimbursement for the procedure.

Given these factors, endoscopic surgeries have been touted as an improvement both in terms of cost and patient well-being. Since the surgeon makes only a small incision in the back to access the diseased area during an endoscopic procedure, the surrounding tissue experiences less damage and the risk of blood loss or infection decreases dramatically.

Typically, patients who undergo a minimally invasive procedure are back on their feet within a couple of weeks.

However, the choice of procedure is not the only decision the patient should spend time researching. It is also very important to select a provider who is not only board-certified, but who offers the kind of comprehensive and integrative services that are fast becoming the gold standard in healthcare.

This includes a team approach to treating back problems, so that there is not just an orthopedic surgeon, but also a pain management expert and a plastic surgeon on hand to make sure the recovery is as smooth and comfortable as possible. Increasingly many practices offer this type of environment.

Additionally, it is crucial that the operating surgeon uses electronic health records to communicate with the patient's primary care physician and other healthcare providers to ensure that both the surgery and follow-up care are done in the safest way possible, avoiding medical errors, harmful drug interactions and duplicate tests. There are many practice frameworks that offer such collaborative environments, including the patient-centered medical home.