The Patient Experience
The typical process for minimally invasive spine surgery begins with an office consultation to look at the patient’s history and conduct a physical examination. The surgeon looks at any appropriate medical imaging like x-rays, CT scans, or MRIs, then meets with the patient to listen to them and hear their symptoms.
The spine doctor will consider their complaints and evaluate the pathology, the objective findings from the advanced imaging, and then formulate treatment options for the patient. Sometimes, surgery is not the first option. Patients sometimes come to us after trying many other options like conservative care, physical therapy, and pain management. Every situation is completely different. However, the patient should feel very certain that when surgery is being recommended, that is the best option for them to permanently resolve their problem.
Prior to Surgery
Before surgery, a patient can expect office visits, possible appointments for imaging and other testing, as well as possible appointments with other specialists to rule out other medical implications or to ensure the correct diagnosis. A patient may try physical therapy or pain management as surgical alternatives to get better first.
Sometimes they are ready for surgery at the time they consult.
During the Surgery
During the surgery, the patient is asleep and cared for by a team of experienced surgical professionals. Besides the spinal surgeon, there is an assistant surgeon, multiple nurses and an anesthesiologist. The medical personnel use fluoroscopy to take x-ray images during the surgery, and neuromonitoring to ensure that there are no neurologic complications during the surgery. Post-operative care will be provided while the patient is in recovery.
On the day of your surgery, our health care professionals make sure patients are relaxed and cared for appropriately. You will likely be visited by many members of our medical team, so be sure to raise any new concerns or questions prior to your surgery.
The anesthesia used on a patient during surgery depends on the recommended procedure for the patient. Most advanced spinal surgeries require general anesthesia, whether it is a minimally invasive spine surgery or a more traditional open back procedure. In some rare circumstances, some of the procedures can be done under a local anesthetic if the patient also has a mild sedation. The main consideration in that situation is the patient’s health.
There is a difference between local and general anesthesia. With local anesthesia, the patient is awake and the doctor can communicate with them. It is possible that a patient may go under some mild sedation from an oral medication to put them in a more relaxed state while a local anesthetic is applied.
With general anesthesia, the patient is not awake to observe or communicate. Usually, there are multiple medications that are involved in general anesthesia to make sure that the patient does not move while he or she is in surgery.
Typically, having the patient under anesthesia renders the patient unable to move and is less stressful to the patient. Sometimes, the noises and the sounds of surgery can be stressful and by providing general anesthesia, we are improving the patient’s experience. There is a benefit to reducing stress in the patient emotionally and physically.
However, the main reason to use a local anesthetic is if the patient has other health complications such as weight. The patient is high risk and may not be a candidate for general anesthesia. If someone has had a prior cardiac issue, they may not be a candidate for general anesthesia.
After surgery, you can expect to be in a recovery room for post-op care. In the following weeks, you must take it easy, attend your post-operative visits, and avoid normal activities until your surgeon gives you approval to do so. Most importantly, you need to recover fully. Spinal surgery is very serious but the risks can be avoided if you take the time to recover.
Our patient care is very consistent. There is not much deviation in terms of how we conduct ourselves, so it is unlikely that one patient has a vastly different experience from another. However, because of the factors we cannot control, such as when a patient suffers a complication from a potential risk, their experience is different from someone who had no complications. It is important to note that the potential for problems is significantly low.
Rehabilitation after back surgery often is not easy or pleasant, but it is vitally important for recovery. Prior to back surgery, speak to your surgeon and a physical therapist and find out exactly what rehabilitation will involve. You must dedicate yourself to performing the necessary exercises and making the temporary accommodations needed in your daily life to ensure the success of your procedure.
Every patient is given an individual rehabilitation plan. If you find post-surgery you are having trouble with your therapy, speak to your doctor or therapist immediately so they may devise a plan you are more likely to follow.
It can take a while to thoroughly recover from back surgery. Pain diminishes over time, but complete healing may take up to a year. Fortunately, most patients can return to work and resume normal – but not overly strenuous – activities within a few months post-op.
During this period, pain levels may fluctuate. It is essential for a person to let their doctor know about any pain they experience, especially if the pain worsens rather than improves over time.