For decades, the measure of success in spine surgery has centered on what happens inside the operating room. The precision of the surgeon’s technique, the use of the right tools, and the application of the latest technology. For many, the narrative/focus of spine surgery begins and ends there. That’s what I was trained to think about in medical school.
Yet, after nearly 25 years of medical practice, thousands of procedures, and countless patient success stories, I have come to realize that true success of spine surgery is not defined by the surgery alone. In fact, much of the success of spine surgery lies in what happens afterward: recovery. This is the phase where skill meets endurance, and where the impact of surgery is truly tested.
So why is recovery so often treated as an afterthought in spine surgery? As surgeons, our duty to our patients extends far beyond the operating room. If our responsibility ends when the procedure does, we’ve missed a defining phase of our patient’s journey.
This shift in perspective has shaped the way I practice medicine and how I believe our entire field must evolve. Too often spine surgery recovery is left to chance, or placed entirely in the patient’s hands once they leave the hospital. Recovery is a crucial component of spine surgery.
It’s where people either regain lives or remain trapped in fear, pain, and limitation—and where the trust in our profession can be lost if we fail to deliver on the promise of true healing. It’s long past time we, as surgeons, give recovery the same strategicimportance as the surgery itself. It is time we reimagine recovery not as the conclusion of care, but as the foundation of it.
Redefining What Spine Surgery Success Really Means
My understanding/experience of recovery began long before I entered medicine. When I was a child, I watched my father struggle with a devastating spinal injury. In the 1970s, spinal healthcare was vastly different from what it is today. My dad underwent a rudimentary spine surgery and spent three months confined to bed in a body cast. As a child, I made a promise to one day help people like him, and his response stays with me to this day: “Oh, son, I hope there aren’t many others like me.” As a surgeon today, those memories inspire me to continuously find better ways/recovery methods for our patients.
Even with the tremendous progress we’ve made in the field, data shows that recovery remains one of our greatest challenges. Nearly half of spine surgery patients initiate a call to their doctor within 14 days of surgery and communication breakdowns are one of the most common sources of complaints following spine surgery. That’s not surprising because studies show surgeons spend the majority of their time discussing surgical options with patients and rarely have conversations about how their patients feel about the procedure or about recovery details.
That disconnect reveals a critical truth: even a technically flawless surgery can fall short if we don’t prepare patients for the physical and emotional demands that follow and nurture them through recovery. Even when the procedure goes exactly as planned, it’s incredibly common for patients to feel unsure in the weeks that follow.
Patients often have questions, like: “What pain is normal? How much activity is safe? How do I rebuild my strength and confidence in my body?” These are defining questions that determine a patient’s outcome, and the challenge here is that recovery isn’t one-size-fits-all.
Each patient’s path to success is shaped by their health, goals, and mindset in addition to the specific structural problem they may have and the procedure that is performed. Many patients require structured physical therapy and exercise to rebuild strength and mobility and achieve full functional recovery. Many patients (especially early in the healing process) can benefit from complementary modalities such as aquatic therapy, acupuncture, massage, laser and hyperbaric oxygen therapy. Success of any surgery depends on preparation before surgery — what we call “prehabilitation.” When patients understand what lies ahead and prepare, their anxiety decreases, their strength and confidence increases, and their recovery accelerates. In many ways, recovery begins before the first incision is made.
Evidence Supports Enhanced Recovery
My colleagues at VSI and I led a national study analyzing more than 50,000 thoracolumbar spinal fusion cases across 138 centers in the United States. The research evaluated the effectiveness of an Enhanced Surgical Recovery (ESR) program/model designed to optimize patient outcomes before, during, and after surgery. It includes pre-surgical education, opioid- sparing anesthesia techniques, and early initiation of mobility and nutrition to accelerate healing and reduce dependence on medications.
These outcomes reinforce a clear message: when recovery is structured, supported, and prioritized, patients heal faster, experience fewer complications, and return to their lives sooner. Recovery is not a passive process; it is an essential, intentional component of success.
Recovery as the Foundation of Surgical (Solution) Strategy
Every patient deserves a recovery plan designed with as much precision as their surgical plan. Achieving that requires coordination: spine surgeons, physical therapists, pain specialists, nutritionists, and medical experts working together to guide the patient through each stage of healing.
So doctors, surgeons and staff – I encourage you to talk with your patients not only about how the surgery will be done, but what happens afterward. What support will they have? What tools will they need? What should they expect on their hardest days? And what can they do heading into surgery to improve outcomes afterward?
The conversation about recovery must begin long before the incision and continue well beyond the hospital stay. Our responsibility as surgeons does not end when the sutures are closed; in many ways, there is much meaningful work still to be done.
Modern spine surgery continues to advance through technology, robotics, artificial intelligence, personalized implants, and minimally invasive techniques. Yet no innovation can replace the human experience of recovery. It is in recovery that patients regain strength, confidence, and identity. It is time we stop treating recovery as an afterthought and realize it’s the key to success.
It’s time we stop treating recovery as an afterthought. and realize it’s actually the key to not only our patients’ success, but also ours.
Dr. Christopher Good is ranked in the top 7% of doctors nationwide. A distinguished leader and pioneer in the fields of spine surgery and nonsurgical spine treatments, he has advanced surgical technology and minimally invasive techniques, significantly elevating outcomes for patients worldwide and getting them back to their lives faster. Learn more at VSISpine.com
