Does spine surgery work?

We often see patients who know of a friend who know of a friend who had spine surgery and “it did not work”. Spine surgery encompasses a very large field that includes treatments for fractures and spinal cord injuries, spinal tumors, disc herniations, scoliosis, kyphosis, cervical myelopathy, stenosis and other conditions that may cause back or neck problems. Each condition carries with it different implications in terms of success of surgical intervention. In general when the right patient has the correct diagnosis and has the correct surgery by the correct surgeon results are generally favorable but individual conditions have variable expected outcome. It is important for the patient to be well educated about what to expect from surgery and have the appropriate goals.

When should I consider seeking out a spine surgeon for back pain or neck pain?

Generally most conditions effecting the spine can be treated by you primary care physician. The vast majority of patients with a degenerative condition causing back pain or neck pain will resolve their symptoms with non operative modalities. Symptoms that do not respond to non operative modalities such as physical therapy, excersises and anti-inflammatories should be further investigated by your primary care physician or sent for a spinal evaluation.

Isn’t Artificial Disc Replacement (Total Disc Arthroplasty) better than a fusion?

Artificial Disc Replacement is an evolving technology that has been under strict trials in the U.S.A for less than 10 years. It has been performed in Europe for about 20 years. The thought behind artificial disc replacement is to eliminate the source of the pain (the lumbar degenerative disc) without eliminating the motion like with a fusion operation. As a surgeon who was an instructor for the Charite artificial disc replacement courses I am very cautious about using this evolving technology. The results so far are equivalent to fusions in general. Some of the potential complications from artificial disc replacement may outweigh the potential benefits and it is important for patients to be well educated. Motion preservation is an emerging field in spine surgery and is promising but it is important to apply it correctly to the right patient. It is certainly not a “magical solution” for low back pain

What is Minimally Invasive Spine Surgery?

Minimally invasive spine surgery or minimal access spine surgery combines the goals of traditional open surgery with smaller incisions utilizing different approaches and retractors. Like anything else when applied in the correct setting minimally invasive approaches can minimize blood loss, operating time and post operative pain. It is important to realize that minimally invasive may sometimes end up being minimally effective if not done correctly or if done in the incorrect setting. We utilize minimally invasive approaches when appropriate and educate individual patients if minimally invasive surgery is applicable to their condition

Should I go to New York or Philadelphia for my surgery?

Having trained in New York (and still occasionally operating in New York at special request) but living in Princeton, this question is often posed to me by patients. Certainly New York has great doctors and I am very fortunate to have a close relationship with my mentors. I would say that it is important for patients in the greater Princeton area to realize that we have top trained surgeons right here with access to hospitals that as far as I am concerned can rival any hospital in New York or Philadelphia in terms of infrastructure. I think you should be comfortable with your surgeon regardless of the location and as far as spine surgery is concerned you can rest assured you have access to several top trained spine surgeons that chose to raise their family right here in Princeton just like you have decided.

Is recovery from spine surgery very painful?

Depending on your condition and what surgery you have recovery varies widely. Patients with a disc herniation that have a microdiscectomy often have minimal post operative pain and in the vast majority of the time go home the same day. On the other hand patients that require a multilevel spinal reconstruction for scoliosis have a much more intensive post operative and recuperative period. Pre operative education and preparation are crucial to the post operative success of the surgery.