5 Spine Surgeons on Common Misconceptions From Patients

Laura Dyrda -  
Here are five spine surgeons discussing the most common misconceptions patients have when coming into their office.Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses. Next week's question: What are the most important benchmarks you use in your spine practice?

Please send responses to Laura Miller at laura@beckershealthcare.com by Wednesday, June 6 at 5pm CST.

Jaideep Chunduri, MD, Spine Surgeon, Beacon Orthopaedics & Sports Medicine, Cincinnati:
A lot of patients think that just because they are coming to a surgeon that all we want to do is operate. I do a lot of conservative care but there are times when surgery is not even an option so I rely on my physiatry colleagues to help take care of those patients.  When looking at spinal surgery, there is in reality no difference between and orthopedic surgeon or a neurosurgeon, you have to go to the doctor that you are comfortable with and give you the best answers for your questions.

Dennis Crandall, MD, Founder and Medical Director of Sonoran Spine Center, Phoenix: "Back surgery is bad." Spine surgery is too expensive for the marginal benefit obtained. I am constantly quoting the literature and our own data to rebut this misconception. Second misconception: using a laser will surely provide a better outcome.

Steven Lee, MD, Spine Surgeon, Muir Orthopaedic Specialists, Walnut Creek, Calif.:
Dubious information from the internet and direct-to-patient advertising are the two main sources of misconceptions in my practice of spine surgery.

The internet is a source of good information for patients to research their various conditions.  However, people sometimes try to diagnosis their own condition and research information that actually have nothing to do with their actual condition.  Anonymous postings or blogs can be misleading. And with more direct advertising, some patients come in with clippings thinking that this one procedure or product will cure them of their problem.  Many people also seem to know a "friend of a friend/family member" who have had "back surgery" and did poorly.

My response to patients is to take the time to carefully state their diagnosis or diagnoses and write it down. Then at least I know they are researching the right diagnosis. I also try to explain that many different types of treatments are performed in spine surgery, such that procedure "A" done for someone who seems to have the same problem as you may not be the best option. In the same way, just because they know someone who may not have had the best result with procedure "A" doesn't mean they will experience the same. If someone would benefit from surgery, I tailor their treatment plan with regard to their specific diagnosis, expectations and various surgical techniques.

For patients undergoing various spine procedures, current techniques have improved results and recovery times. Many people are surprised that they can return to activities and/or work much sooner than expected.

Finally, as much as I would like to be able to completely "cure" someone of their pain or problem, not every patient has a straightforward treatment solution. Surgery is not appropriate for every patient. When there is not a "quick fix or procedure/surgery" to help them, I utilize a lot of counseling time to encourage lifestyle changes, promote healthier habits and maximize non-surgical treatments to better manage their symptoms and improve their daily functional abilities.

Nick Shamie, MD, Co-Director of UCLA Comprehensive Spine Center:
"Spine surgery is dangerous." Most patients who come to our offices have been warned by friends, neighbors, media and even PMDs that "back surgery" can cause disability so "don't have back surgery." I often have to educate patients on how safe spine surgery has become over the last few decades/years. We have new and improved techniques, instruments, institutional safety measures (i.e. Time-out before surgery) and overall a better understanding of who can benefit from surgery based on specific diagnoses. I tell patients what they hear in the news is not the norm but the exception…you always hear about the person who was killed on the freeway on their way home from work; you never hear about the millions who made it home safely and are enjoying a meal with their family!

Scott Tromanhauser, MD, Spine Surgeon, Boston Spine Group:
Many patients think that we can solve all problems with surgery, particularly when nothing else has worked for them. There are clearly some problems that will benefit from surgery and the results are quite predictable, e.g. spinal stenosis, disc herniation or instability from spondylolisthesis. Beyond those diagnoses the results become far less predictable and in some cases predictably poor. In those cases, there is usually little else to offer and the patients find that very distressing.

More Articles on Spine Surgery:

How Often Should Spine Surgeons Renegotiate Vendor Contracts?

What Are the Biggest Inefficiencies for Spine Practices?

8 Spine Surgeons on the Future of Spinal Fusions

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