Good Morning Spine

I am amazed how many patients do not realize the extensive care necessary after spinal surgery.I typically see patients within five days then two weeks then three weeks if everthing is going perfect. You need to be near your surgron for comprehensive care. If distance is a problem , each patients has my home and cell number. I want to know immediately if patients are have increasing pain or symtoms of wound infections. Do not underestimate how important knowing that u can reach your surgeon!

I like to really stress nutrition and weight prior to spinal surgery. Many patients are in poor general health which increases potential for complications.Surgery is an assault on your immune system and basic wellness is essential. Technology can not make up for this!

Each time I see a patient, I try to understand how they must feel after trying so many different treatments from various doctors or therapists. The most important thing is a proper diagnosis! This may require several things including MRI or a visit with my partner Dr Geisse to perform very specific nerve testing. So much of good outcomes requires a thorough review of these tests. I even have a new Dr that specializes in gait to look at patient’s shoes and how they rotate their pelvis when walking. The goal is less surgery and more using a team approach to decrease pain and increase function for the vast majority of patients with neck and back pain.

I think how much trust a patient needs to have to move forward with spinal surgery on the neck and back region given all the bad press regarding spinal surgery. A lot of this is actually good as patients should be cautious on making any decision. There are real risk and surgery gives less then perfect results. However, there is a window after which results are less certain if chronic weakness and pain are treated with narcotics and excessive nerve blocks. Know your options and research on the Internet as well. Education is a fundamental goal in my practice with all patients.

Do yourself a favor and aak about your post- operative care. Who is going to make rounds and explain what was done. Surgeon tend to make smalll changes that are in the consent but can be confusing. I make this clear prior to surgery as each case is quite unique. Please also look at new section at top for consultation from outside the Florida area.

I try to always give options as no results of surgery are perfect. However, improving quality of life and allowing activity do occur after surgery when I involve the whole team at this Institute. Each physicians adds his or her perspective prior to my offering surgery. I am still amazed that patients accept surgery after one visit lbinder@bindermed.com with some doctors without carefully reviewing all options. There are exceptions that require immediate surgery but not common. Younger patients need to bbe careful and review the fine details. Yet, when properly diagnosed, neck or lumbar surgical decompression does offer a fairly low risk solution. Just review a complete plan of treatment with your doctor.

I read a lot about laser for spine surgery. This tool is very easy to use but has very little role for treatment of spinal disorders. There are reasons most advanced trained surgeons do not use it. We would if it help with outcomes. Most of these “lasercenters” do not have peer-reviewed content or doctors that have felllowships in spine. Procedures are performed outside a hospital where Bthere is much monitoring of complications and efficacy. If u are thinking of this option do a complete Internet search of a center including complaints to board of medicine,lawsuits,and community chat centers. Be careful!

I wonder how difficult patients must have making clear decisions given all the misconceptions about spinal procedures. I try to let them know that non- surgical choices are good as long as there is real improvement. However, I see a lot of patients using drugs that are just masking symtoms that really do not address the compression of the spinsl nerves. If one has weakness lifting their arms or difficulty walking from leg eakness this is very serious. Most of the time, surgery is to remove compression of nerves by either a disc or bony overgrowth that cannnot be avoided. My best outcomes occur if a decision for surgery occur before there is permanent damage to the spinal nerves from chronic compression in either neck or back. Be very careful with overuse of pain medications or prolong therapy!

I strongly believe spine surgeons should discuss all serious potental complications with surgical patients.I feel that patients should be a little nervous if they are properly prepared for surgery. The results are good but not perfect In most situations. Managing each patients expectations is extemely important. I also find the other extreme, where patients with very correctible problems , are told surgery on their neck or back will not work. In fact, surgery has come along way over past five years with newer technology and more more highly trained spine specialists. Too much narcotics are being prescibed that have no proper role for treatment of stenosis or herniated disc disease.

I read a lot of articles about repeat spinal surgical procedures and want my patients to understand some basic reality.In most cases, the underlying process is a form of aging with degeneration of structures such as disc or facet joints. This ongoing process cannot be changed with surgery. Rather we try to lessen the symtoms of pain or weakness so a patient can be more functional. The undelying process may then pass on to other levels with time requring either non-surgical or possibly more surgery in the future. This process is seen quite often in heart surgery as well. Coronary arteries at other level also nay get blockage over time needing second and even third surgeries. I clearly relay this process to all my patients. Fortunately, new techniques for spine surgery make recovery very rapid from just a few years ago.