In the old days, a doctor would say to a patient, "you need surgery" and the decision was made. These days, unless it is an emergency situation, patients are active participants in the decision-making process and are ultimately responsible for deciding whether or not to undergo spine surgery. The following information may be of some help when you are faced with the question, "Should I or shouldn't I have spine surgery?"

Your Job
It is totally up to you whether or not you have spine surgery—no one can force you. Your job is to make the final decision. Therefore, it's important that you consider the pros and cons, risks and benefits, and potential for success. If you decide to go ahead with the surgery, you need to feel confident about that decision so you can approach the procedure with a positive attitude, realistic goals, and a clear understanding of what the surgery is supposed to accomplish. Your recovery will be greatly enhanced if you maintain a positive mental attitude.

The best way to accomplish this positive attitude is to learn all you can about your condition and the recommended surgery. Ask as many questions as you need. Make sure you know what the surgery is supposed to do, how it will be performed, and what to expect after the procedure. Ask your doctor if he or she can give you any written information or direct you to other resources such as books, brochures, websites, or videos so you can learn more about your condition and the recommended procedure.

Your Doctor's Job
One of your doctor's jobs is to provide you with the essential information with which you make your decision. Once your doctor gives you a thorough examination, evaluates your condition, and determines a diagnosis, make sure you understand what your condition is as well as what caused it. Ask as many questions as you need. The physician should also talk to you about any and all treatment options that are available to you and make a recommendation on how to proceed.

The information your doctor provides should help you make an informed decision about whether to have surgery. If you feel you have not been given enough information to make a decision, ask more questions. Never feel like you are bothering the doctor with too many questions. The most important thing is that you understand your condition and treatment options. Getting a second opinion is also a great way to get additional information to help you make a decision.

Know the Risks
All surgeries carry a risk of complications such as infection, excessive bleeding, reactions to anesthesia, and injury. Some spine surgeries also carry additional risks such as numbness, nerve damage, paralysis, or a loss of bowel and bladder control. Be sure you understand all of the possible complications before you agree to have any surgical procedure. Most spine surgeries today are considered safe, but you should discuss the risks associated with your surgery with your physician.

When considering your options, keep in mind the risks of not having surgery, such as continued pain, further nerve damage, or permanent disability. What impact does your condition have on your quality of life, and how will that be affected if you do not have surgery? Think carefully about the risks and benefits of having the surgery as well as the risks and benefits of not having the surgery.

If You Decide to Have Surgery
Do you feel good about the decision? If so, you've made the right choice! Think of your spine surgery as the first step on the road to recovery. Carefully follow your surgeon's instructions, and focus on reaching the goal of improving your health. Once you are confident that spine surgery is your best option, you can begin to focus on the future and the recovery process.

Commentary by Lali Sekhon, MD
Dr. Silveri provides an excellent guide that ALL patients should read if they are contemplating surgical intervention. In today's age of being informed, not only is it the responsibility of the surgeon to thoroughly delineate the risks, benefits, alternatives and likely outcomes of any surgical intervention, but it is also the responsibility of the patient to be informed, aware and understanding. I have no doubt that those patients who understand their disease better do better from the surgery.