When To See A Spine Surgeon

Most people experience back or neck pain at some point, whether it’s a strained muscle or it develops over time. But if you have severe back pain; pain, numbness or weakness that extends into your arms or legs; or back pain along with bladder or bowel problems, these can signal a neurological problem that needs attention.

“A spine surgeon should evaluate these symptoms,” said Daniel Spomar, MD, an independent neurosurgeon specializing in spine surgery who chooses to practice at Franciscan Health Indianapolis. “For most people, over-the-counter pain medicines like ibuprofen or Tylenol, rest, and ice or heat packs relieve pain. But neurological symptoms like these should be evaluated.”

Dr. Spomar added that most people with back pain don’t need surgery. Often, physical therapy, spinal injections, exercise and other nonsurgical back pain treatments offer relief.

“We always consider nonsurgical treatments first,” Dr. Spomar said. “But if someone has weakness or significant nerve damage, nonsurgical treatments may not help or may even worsen the pain.”

How Do Surgeons Determine When You Need Surgery?

Surgeons evaluate your symptoms, physical exam findings and imaging results to determine treatment. They consider surgery only if it’s the best way to treat your condition. Spine problems that often require surgery include:

• Herniated disk pain that hasn’t responded to other treatments
• Spine joint abnormalities, such as sacroiliac or facet joint problems
• Scoliosis (irregular spine curvature)
• Spinal stenosis (narrowing around the spinal cord and nerves)
• Spondylolisthesis (slipped vertebrae)
• Damage to nerve or spinal cord

“We always look for the least invasive surgery to correct the problem,” Dr. Spomar said.

The Benefits And Risks Of Spine Surgery

The benefit of spine surgery is relieving symptoms – either they go away or they’re significantly reduced. When surgery is the well-accepted approach for a particular spine condition – and the surgery is done by an experienced surgeon – most patients do very well, according to Dr. Spomar.

“People return to an improved quality of life compared with how they felt before surgery,” he said. “They can do things they couldn’t do before.”

But no surgery is without risks. With spine surgery, you may not feel better, or your symptoms could get worse. You may need another spine surgery to address a problem with the first surgery. Although rare, other potential complications can include:

• Bleeding
• Blood clots in the legs
• Infection, including pneumonia
• Spinal fluid leaks

“We take every precaution to ensure surgery is safe and effective,” Dr. Spomar said. “If surgery is the best option, we want you as healthy as possible before surgery. For example, we have you lose weight if you’re overweight or quit smoking if you smoke. If you have diabetes, high blood pressure or another condition, we make sure it’s well-controlled beforehand to ensure the best possible outcome.”

Finding The Right Spine Surgeon

Choose a surgeon trained through an accredited medical program who has plenty of experience with the procedure you’re having.

“Neurosurgeons do hundreds if not thousands of procedures during residency,” Dr. Spomar said. “Ask your surgeon about their experience with the surgery you need. Choose someone with a good reputation, significant experience and high-quality outcomes.”

Learn as much as you can by asking:

• What is your expected success rate with this particular surgery?
• What are the possible complications and how likely are they?
• Are there other alternatives to consider, such as nonsurgical or minimally invasive approaches?

“Ultimately, you have to decide if surgery is right for you,” Dr. Spomar said. “I tell my patients if they can live with their symptoms and they’re tolerable, surgery might not be right. You should only have surgery if your symptoms significantly affect your quality of life.”

You should also consider the facility’s or health system’s reputation. Choose a provider with experience caring for spine surgery patients.

“At Franciscan Health, our nurses and surgical technologists are trained to assist and care for spine patients before, during and after surgery,” Dr. Spomar said. “Our experienced anesthesia providers ensure patients are safe and comfortable during surgery and their pain is well-managed after surgery. It takes a team – not just the surgeon.”

If you have questions or concerns about your care, get a second opinion from another spine surgeon and make sure they agree the treatment plan is the best one for you, he added.

Leading-Edge Technology For Better Spine Surgery Outcomes

Recent advances in spine surgery technology have helped improve patient safety and outcomes.

During spine surgery, surgeons use equipment that offers real-time pictures of your spine.

“Imaging guidance allows us to place devices – such as screws, rods or cages – in the spine with greater accuracy and consistency,” Dr. Spomar said. “This is one of the best surgical advancements.”

Some surgeries use devices called expandable interbody cages to create space between vertebrae (spine bones).

“The cage is compressed when we place it in the spine, and then it expands once it’s in position,” Dr. Spomar said. “This reduces the risk of damaging the spinal cord or nerves.”

These advancements allow surgeons to treat spine conditions in the safest manner possible, he said.