Choosing Your Back Surgeon

Choosing Your Back Surgeon

The decision to have back surgery is a difficult and deeply personal decision.  Back surgery does not always work, the spine is difficult to operate on, and the side effects, including spinal nerve damage, the deterioration of spinal discs not operated on, and procedures that must be redone every few years, can severely outweigh the benefits to providing what at times can be limited relief to chronic pain.  For those who do elect back or spinal surgery, choosing a surgeon with the appropriate experience, with whom you are comfortable, and with a position at an accessible hospital, is an important step that should not be overlooked. 

Questions to ask your spine surgeon

Once you have decided to seek care for your back pain and your primary care physician has referred you to a specialist, you should be ready to ask your back surgeon questions about not only the cause of your pain and the procedure but also the surgeon’s success rate for the particular procedure. 

Questions you should ask your doctor:

  • Do you know the specific cause of my pain?  If the surgeon cannot pinpoint the origin of the pain, it is difficult to determine the best treatment for it. This is especially true for back surgeries.  With the advanced imaging systems available, back surgeons should not recommend exploratory surgery.  The surgery should be directed at alleviating the pain, not discovering its source.
  • How many times have you performed this procedure? Usually, the more practice that a surgeon gets, the better that surgeon will be.  If the procedure the specialist recommends, however, is extremely rare, a high number may be a warning sign that the doctor takes risks. 
  • What is your general success rate for this surgery? What is the general success rate nationally for the procedure?
  • What are the side effects and complications associated with this surgery?  How often do these happen?  How long might they last?
  • Can I talk to other patients for whom you have performed this procedure?
  • Will you be available to follow up with me after my surgery?  How regular will these appointments be?  Like any operation, it is important to be able to have access to your physician after the procedure to ensure that the healing process is progressing in an appropriate way.   
  • If I were to look for a second opinion, who would you recommend?
  • Would you recommend this procedure to a close friend or family member?

Your spine specialist should be able to answer these questions without hesitation.  Be wary of surgeons who discourage seeking a second opinion, do not want to answer your questions, make you feel bad about asking questions in the first place, encourage exploratory surgery, suggest surgery without exploring non-surgical restorative options, or who are not forthcoming about the costs of the procedure.  Like with all doctor-patient relationships, it is vital that you feel comfortable with your spine surgeon.     

Board Certified or Board Eligible? Your Surgeon’s Qualifications and Experience

In addition to the above questions, it’s important to ask your surgeon about his or her qualifications and experience with the procedure itself. 

General Experience and Qualification Questions

Many physicians are licensed to practice but are not board certified.  Board certification is a voluntary process not required to practice medicine.  The certification indicates that physicians have completed additional testing for their specialty.  Board certified physicians are re-certified every six to ten years to ensure that they remain familiar with research and development in their field.  Ask your surgeon:

  • Are you board certified or board eligible?
  • Are you fellowship-trained in back surgery? Surgeons who are fellowship trained have completed at least one additional year of work past their residencies.  This extra year of preparation focuses specifically on spinal surgeries.

It is relatively easy to determine whether the surgeon you are considering is board certified. The most popular and easiest way to determine whether the surgeon you are considering is board certified is to check with the non-profit organization American Board of Medical Specialties (ABMS).  The ABMS collaborates with twenty-four different accreditation boards in the United States to make it easier for patients to find the most qualified physicians available.  Patients can visit the ABMS’s website and use their search function on the organization’s home page to determine whether their surgeon is board certified.  Through the ABMS, patients can also learn about the certification requirements from individual boards.  Spinal surgeons are most often certified with either the American Board of Orthopaedic Surgery or the American Board of Neurological Surgery.  The American Board of Spine Surgery is a newer organization that is not associated with ABMS and also certifies spinal surgeons. 

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