Weighing Risks And Benefits - When Surgery Is An Option: Back Pain
Content provided by the Faculty of the Harvard Medical School
Weighing risks and benefits
Weighing risks and benefits
All operations carry the risk of infection at the site of the incision. Also, anyone who is planning to undergo general anesthesia should be aware that approximately 1–2 patients in 44,000 fail to regain consciousness afterward. In addition, there are two serious — but very rare — complications of back surgery. You may experience weakness, numbness, or tingling in one or both legs. And there is the chance of bleeding from the large vessels that lie in front of the disks, which can be damaged during the procedure. Although dangerous, this is extremely rare when an experienced orthopedist or neurosurgeon performs the operation (see "Choosing a surgeon").
Choosing a surgeonIt's important to choose a surgeon carefully. A good place to start is with a referral from your primary care doctor. Another good idea is to get recommendations from people who've recently undergone successful back surgery. Training and experience in back surgery are essential, as is board certification in orthopedic surgery or neurosurgery. In addition, look for a surgeon who is attentive and concerned about you and takes the time to answer questions in appropriate detail. It's important to ask a surgeon about his or her experience and comfort with a specific operation, and to get a direct, candid response. |
Deciding to have back surgery — even when medically advised — is a big decision. How do you make it? One way to do this is to answer the questions below. There are no "right" answers — only your answers.
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Do you fully understand everything there is to understand about your back problem? Your answer should include up-to-date information about your condition, the various ways to treat it, and the likely outcomes of these treatments.
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Have the risks and benefits offered by surgery for your back problem been explained to you, in a way that you understand?
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Do you know the likely natural history of your back condition so you can choose between a wait-and-watch approach and surgery?
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How do you feel about taking risks of any sort? Consider your personality, lifestyle, age, other medical conditions, and so forth.
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How do you feel about the risks associated with both the surgical and the nonsurgical treatment options for your back problem?
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How much functionality do you want, and how much risk are you willing to take to get it? A professional athlete would most likely want more functionality and be prepared to take more risk. For most other people, the stakes are not so high.
Talk these questions over with your physician. A careful and thorough discussion between you and your physician will help you reach an informed, preference-based decision that is right for you.
After surgery
The guidelines for recuperation after surgery depend on the particular operation you have undergone. Your surgeon will help you work out a specific program for recovery, which typically includes physiotherapy. Generally speaking, pain medications should be used generously in the first few days following the operation. It's important for you to be out of bed, sitting up, and walking as soon as possible after the procedure, although you should resume exercise and increase activities gradually. Talk to your doctor about the specific timetable that is right for you.
Fast factOne study of back surgery in 11 countries — including Sweden, England, Australia, Denmark, and Norway — found that the rate of back surgery in the United States was 40% higher than that of any other country surveyed. But all that extra surgery doesn't seem to be helping: The rate of work disability is just as high in the United States as it is in these other countries. |
| Last updated: | January 23, 2007 |
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Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
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