In today's medical world, the patient is at the center of the decisionmaking process.Ultimately, it is up toyou to decide, with a lot of help from your doctor, whether or not spine surgery is right for you. Trying to make a decision about whether or not to have spine surgery can be an overwhelming process. How do you start to make this decision? Our recommendation is that you begin by learning as much as you can about why you need surgery, what kind of surgery you are going to have, and what this will mean to you and your family.

Having a complete understanding about the surgical process and what to expect will help to ease some of the anxiety that you will naturally have about this decision. It is best to go through a step-by-step process, beginning by educating yourself, that will guide you towards an informed, confident decision made jointly by you and your doctor about whether or not to have surgery.

Take an Active Role in Your Medical Care
Experience has shown that patients who are given the opportunity to make decisions about their own health care have less anxiety before their surgery and recover more quickly after their surgery. Recognize that you have a right and a responsibility to participate in the decisions involving your health care.

Your Doctor Can Help You with This Decision
You and your doctor will need to work jointly towards determining what is the matter with your back (or neck), what this means to you and your family, and what can be done about it. Your doctor will guide you in the process of understanding your problem and how you can make an educated decision about whether or not surgery will help you.

If you choose to have surgery, your physical condition and your mental attitude will determine your body's ability to heal. You must approach your surgery with confidence, a positive attitude, and a thorough understanding of the anticipated outcome. You should have realistic goals.

Even if your surgeon does a brilliant job and you work hard towards recovery, it is possible that you may still feel that there is room for improvement. The body is a complex machine and its response is not always predictable. No one will give you a guarantee about how spine surgery will make your life better, but have faith in the fact that many spine surgeons believe that their patients are much better off, after surgery, more than eighty percent of the time.

The decision to have or not to have surgery includes weighing the risks and benefits involved. You will make the final decision, so ask questions about anything you do not understand. You must have a thorough understanding of the diagnosis (for instance, what causes your back or leg symptoms) and the risks and benefits of the proposed surgery. Once you are confident that surgery is the correct option for you, turn your thoughts to the future and the recovery process. If you do decide that surgery is the best option for you, then we suggest that you further consider the nature of your proposed operation, the potential risks and alternatives, and the expectations for the recovery process.

Your Chances for Success
The effects that spine surgery will have on decreasing your pain and improving your quality of life is impossible to predict with absolute certainty. Your age, your general health, the severity of the damage to your back before surgery, as well as your attitude and your willingness to work at recovery will all influence the amount that spine surgery helps you.

Making Your Decision
When you consider your options, keep in mind the impact your condition has on your way of life and carefully weigh the risks and benefits of having surgery against the risks and benefits of not having surgery. The decision is yours!

Risk
Certain risks must be considered with any surgery. Although every precaution will be taken to avoid complications, among the most common risks possible with surgery are: infection, excessive bleeding (hemorrhage), and an adverse reaction to anesthesia.

Other risks possible when anterior cervical fusion include: stroke, injury to the recurrent laryngeal nerve, which causes hoarseness and may or may not be permanent and injury to the involved nerve root(s) or the spinal cord, both of which can cause varying types and degrees of paralysis.

Clinical experience and scientific calculation indicate that, in general, surgical risks are limited; however, surgery is a human effort. Unforeseen circumstances can complicate any surgical procedure and lead to serious or even life-threatening situations. Although such complications are rare, you should feel free to discuss the question of risk with your doctor.

• Expect the unexpected. You are a unique person. Because every patient and every spine surgery is a little bit different, it is impossible to predict or plan for all of the possible situations that may occur during your surgery and your recovery. Trust your doctor and believe that he or she wants the best for you. This will help you to work towards your goals as part of a team that includes you, your family, and the doctors who will take care of you.



• Spine surgery is hard work. It can take a long time for you to feel like yourself after an operation on your back. During this time, you will need a lot more help around the house. Many times, you and your family will find that adjusting to your needs after surgery is a challenge. You can make this process easier by having realistic expectations about how spine surgery will affect your independence, and what this will mean to your family.



• Educate yourself and your family about your spine surgery as much as possible. It is your job to learn as much as possible about spine surgery and rehabilitation and communicate this information to your family. If your family knows what to expect, it will be much easier for them to understand what you are going through and how they can help.



• If you don't know, ask. Your spine surgeon and physical therapist are both there to help educate you as well as to help you heal. If you want to know something, ask them! Don't worry about appearing "stupid" or overly concerned.



• Your family, your support system. Try to establish clear channels of communication in your family so that you can convey exactly what you want and need after your operation without fearing that you appear weak or may be burdening them. Recovering from surgery can be extremely difficult and it can also be hard work. This process requires patience, encouragement, consideration, and a positive attitude both from you and your family.



• Being disabled isn't easy! This may sound obvious, by many people are surprised at how difficult it is to return to normal after spine surgery. Crutches, a walker, or a wheelchair can be difficult to use in your house, and many people find it very frustrating to depend on others to help them get around. It can be very stressful from an emotional point of view to suddenly loose your independence, even if it is just for a short time.



• Planning for your rehabilitation. After your surgery, you will need a lot of help with simple household tasks, caring for yourself, and making it to your return appointments. It helps to plan ahead, especially because simple tasks can take much longer and be much more difficult if you need assistance. You should plan with your family how you are going to get to your appointments with your doctor and physical therapist, and how you are going to do simple things like bathing and cooking your meals. Having a clear understanding of who will be available to help you with these tasks can help you to avoid some possibly difficult situations after your surgery.

Do I need a fusion?
The main reason that a fusion is performed is in order to provide stability to the spine in certain situations. A fusion will make two separate bones in your spine grow together so that there is no motion between them. Movement is a natural part of the normal function of your spine, and surgeons will try to prevent this movement in situations where the motion between two segments of the spine may be the source of your pain. This usually occurs when your spine has too much motion, has degenerated to the point where any motion is painful, or a correction of a deformity of the spine is needed.

Do I need hardware? If so, what type?
All spine hardware is designed to stabilize the spine until a bony fusion can form. Therefore, hardware is only used when a fusion between two or more segments of the spine is a goal of the surgical procedure. The manner in which hardware is used is dependent upon your surgeon's preferences, his or her past experience, and also on the quality and mineral content of your bones. From the patient's perspective, it is more important to understand why hardware is necessary rather than focus on the specific type of hardware that is being used.