Do You Need Surgery?
- 06-15-2006, 10:47 AM
Do You Need Surgery?
What kind of doctor should I see?
A spine surgeon. This can be either a neurosurgeon or an orthopedic surgeon who concentrates on backs and ideally has completed a fellowship in spine surgery, says David A. Ditsworth, M.D., a neurosurgeon in Los Angeles. Either way, you want someone who does at least 100 spine operations a year, says Zoher Ghogawala, M.D., a professor of neurosurgery at the Yale University medical school. Start your search for a surgeon at spine-health.com.
What will he do?
Take x-rays and an MRI and look for anything that may be inflaming nerves--misalignment, narrowing disks, bone growths called osteophytes, but especially a herniated disk. That would mean the rubbery nucleus of a disk is protruding through its fibrous casing, the annulus, possibly compressing a nerve.
How will he know if surgery is needed?
"It's pretty obvious" in most cases, Dr. Ghogawala says--for instance, if a large piece of extruded disk is pressing on nerve endings and your pain is continual. If it's a slight herniation, he may suggest waiting to see if it subsides.
How serious is the operation?
Spine surgery is always serious. But if just a small part of the nucleus protrudes, ask about less-invasive endoscopic surgery, in which the nucleus is trimmed through a tiny tube inserted between muscles.
How long will I be laid up?
Dr. Ditsworth says he routinely has patients going home the day after endoscopic surgery. "Open" operations typically mean a night or two in the hospital, a return to work in a few weeks, and several months of rehab before resuming athletics.
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