Why Your Spine Surgery Might Fail Even With The Best Surgeon
5 Questions to Ask Before Your Spine Surgery
Before you agree to spine surgery, there are five crucial topics you need to discuss with your surgeon—topics most patients don’t know to ask about.
As a board-certified neurosurgeon specializing in spine surgery, I’ve noticed a concerning pattern: many patients come to their consultation focused solely on when they can have surgery, believing it’s their only option for relief. They’re tired of living with constant pain and numbness, worried about worsening weakness, and most importantly, they’re terrified of making the wrong choice about their care.
But here’s what’s critical to understand: spine surgery is a significant decision that requires careful consideration and clear communication with your surgeon. Today, I’m going to walk you through the five essential conversations you need to have during your spine surgery consultation. These discussions often reveal crucial information that can completely change your treatment path—and these are the exact conversations I have with every patient before surgery.
1. Goals and Benefits
This might seem obvious, but it’s often where patient-physician relationships become misaligned. Your goals and your surgeon’s goals must align perfectly for optimal outcomes. For example, your primary goal might be to cure chronic low back pain, but your surgeon’s goal might be to improve your leg pain. That misalignment can lead to disappointment if it’s not addressed upfront.
During this discussion, be specific. Ask your surgeon: “What exactly is your goal for this surgery?” “What symptoms will it help with?” “Which symptoms might it not help with?” The answers might surprise you. Some surgeries aimed at nerve pain may increase the risk for worsening back pain. These are the details you need to weigh carefully.
2. Risks of Surgery
Every surgery comes with risks. Understanding those risks—especially as they apply specifically to spine surgery—is essential. First, there are standard surgical risks from general anesthesia: heart or lung complications, infection, poor wound healing, and blood clots. Then there are spine-specific risks, which vary based on the surgery’s location.
Neck surgery carries risks to structures like the esophagus, trachea, vocal cord nerves, and major blood vessels. Low back surgery has different risks, especially when hardware is placed for spinal fusion. These potential complications should be discussed clearly so you can decide whether the benefits outweigh the risks.
3. Alternatives to Surgery
Before moving forward with spine surgery, you must understand all non-surgical options available. Ask yourself: have you tried everything? This includes injections, physical therapy, specific exercise programs like yoga or aqua therapy, medication regimens, and even weight loss programs. The timing and consistency of these efforts also matter. Two weeks of PT isn’t the same as a 3-month program. One type of injection may fail while another might offer relief. You and your surgeon should thoroughly explore these options before committing to surgery.
4. Expectations
This conversation should include the post-operative recovery process and long-term expectations. Will you experience pain? How long will it last? Will you need help at home? When can you return to work or drive? Are additional surgeries possible down the road?
Some conditions require staged procedures or may carry a higher risk of needing revision surgery. Knowing what to expect—and preparing for it—is just as important as the procedure itself.
5. Post-Operative Instructions and Limitations
This final conversation focuses on your lifestyle after surgery. Will you need to wear a brace or collar? For how long? Are you restricted from bending, lifting, or twisting? If you enjoy activities like cycling, horseback riding, or travel, when can you resume them safely?
Can you return to work right away? What tasks will be limited? If your job is physically demanding, you may need significant time off. Understanding these restrictions in advance will help you make the right decision—and be fully prepared for recovery.
These conversations take time and require a surgeon who’s willing to listen and explain. If you feel rushed or dismissed during these discussions, it’s a red flag. A meticulous surgical outcome starts with meticulous planning and education.
Spine surgery isn’t just a technical procedure—it’s a journey. A successful result requires clear understanding and mutual trust. These five crucial conversations could be the difference between a confident, informed decision and a regretful one.
Some patients, after having these discussions, decide to proceed with surgery. Others realize there are alternative paths. But what matters most is that they make the decision that’s right for them.
If you’re considering spine surgery, save these topics and use them as your consultation checklist. The key to success is not just surgical expertise—it’s also knowing your options, your condition, and your goals.