Surgery for Herniated Disc with Sciatica: Find the Right Surgeon, Ask the Right Questions
Several types of procedures are performed for spinal problems. The type of surgery you need depends on your specific spinal condition and your general physical health.
Assuming that surgery has been recommended for your lumbar herniated disc (LHD) and sciatica, the first step in getting well and pain free is finding a surgeon who is a good fit for you.
How should I choose a spine surgeon?
Choose a doctor with good credentials: a board-certified (or board-eligible) surgeon who has completed a fellowship in spine surgery, who devotes at least 50% of his or her practice to spinal conditions, and who specializes in treating LHD and sciatica. He or she will have special knowledge and expertise.
Moreover, it is important that you feel comfortable and can communicate well with your surgeon. You know you can trust your surgeon when he or she...
- Spends enough time with you.
- Answers all your questions and provides you with all the information you need about your condition and its treatment.
- Listens to what you have to say and is open-minded.
- Is reachable.
- Is experienced in the latest approaches and techniques.
You will most likely have several questions for the surgeon. Make sure he or she addresses your concerns.
What should I ask my surgeon?
Patients often feel uncomfortable asking questions of their doctor, but good communication with your surgeon is key. You are a part of the team: it is your body, and it is your right to know the details of your spinal disorder, as well as nonsurgical and surgical approaches to treatment that are available to you.
Most spinal procedures are elective; in other words, you have time to consider your options and make an informed decision about your treatment.
Asking your surgeon the following questions will help you reach your decision wisely and comfortably.
- What is your focus? Both orthopedic surgeons and neurosurgeons perform spine surgery. Each surgeon may have a special interest and expertise in certain spinal condition: some treat either adult or pediatric patients, and some treat either lumbar or cervical (neck) disorders, and within those groups, some focus on spinal deformity, tumors, myelopathy (spinal cord disease), or spinal deformities.
- Do you perform minimally invasive spine surgery? Minimally invasive spine (MIS) surgery is performed through tiny incisions, reducing the amount of time needed to heal. Patients can be up and walking within hours after surgery. Although not all conditions can be approached through MIS surgery, it is a good option for many patients.
- Is the surgery necessary, or can my LHD/sciatica be treated nonsurgically? Sciatica and LHD can be very painful and cause disability. However, don’t rush into surgery just to relieve your symptoms. These conditions can often be resolved with medications, injections, physical therapy, and lifestyle changes such as regular exercise or weight loss. If you are exhibiting neurologic signs and symptoms, such as weakness in your leg and/or foot, numbness, or loss of bladder or bowel control (which is a medical emergency), surgery is indicated.
- How many procedures like mine have you performed? Your surgeon’s experience in treating your condition is very important: the more experience, the better. Ask if he or she can refer you to other patients who have had your planned procedure.
- How long will my recovery be? Each patient is different, as is each type of surgery, and recovery time varies accordingly. Your general health and physical condition, as well as the severity of your spinal disorder, will play a role in how long and how involved your recovery will be. An experienced surgeon will be able to provide answers specific to you and your surgery.
- What is your complication rate? Any surgery carries the risk for complications. A complication rate of more than 10% is a red light: that surgeon may have an excessive number of complications.
- What is your infection rate? A surgeon should have an infection rate lower than 10%. A higher rate does not necessarily mean that surgeon is at fault: he or she may perform very complex procedures, or the patients themselves (eg, smokers or people with diabetes) have higher risks for infection. You should not feel uncomfortable asking the surgeon to explain a high infection rate.
- What if I don’t opt for spine surgery? When your surgeon gives you a diagnosis, he or she should present you with a recommended treatment plan, including alternative therapies. Don’t be afraid to ask for another explanation of any part of your evaluation, diagnosis, or treatment options.
- Is it okay if I get a second opinion? A second opinion can be a good thing. It can reinforce your surgeon’s recommendations or give you another perspective on treatment. Your surgeon should be comfortable with a second opinion. It doesn’t mean that you don’t trust your surgeon. It does mean that you take an interest in your health care and that you want to be sure you’re doing the right thing. If the surgeon discourages, or doesn’t allow, second opinions, you may want to look elsewhere.