Introduction to Surgery

By Guy O. Danielson, III, MD

The purpose of this section is to provide specific information to our patients about the various surgical procedures that are performed at NeuroCare.

Step One: Rule Out Non-Surgical Approaches to Healing

Surgery will become an option for pain relief only when all other avenues to resolve the problem have been exhausted. Your surgeon will outline the options to resolve your condition beginning with the least invasive treatment, reserving surgery as the "last resort."

Maximize Healing

One aspect of this process needs to be emphasized from the start. There is a popular conception that our bodies function like a machine such as a lawnmower, and that when we have a problem, surgery is mainly designed to repair or "fix" the problem. The human body should be compared to other living organisms that possess the power to heal and mend on their own. We like to refer to surgery as a systematic way of creating the best circumstances for the body's healing power to occur. This is quite important. Major spinal conditions that have existed for years may require surgical procedures that are elaborate and extensive, and it is natural for the healing process to take a considerable length of time. Understanding this in advance is very important, and if you have doubts about this, you should discuss them with your surgeon.

Addressing Fears and Concerns

Surgery is a major event in one's life, and the decision to undergo surgery may be a difficult one. We hope that fear, anxiety, and stress involved with this decision will be lessened by having detailed information about the proposed surgery. While there is no way to avoid fear entirely, fear of the known is usually less than fear of the unknown.

Team Approach to Healing

As surgery moves up on the list of options, your surgeon will discuss potential advantages and disadvantages with you and your family, forming a "partnership" for healing. You must have information that will allow you to decide which treatment is best for you.

Your Surgical Team

We are strong proponents of a "team approach" to medicine. Everyone on your team will do their best to help with your care, and will work together to meet your needs.

The Surgeon

The surgeons at NeuroCare Network are all board certified neurosurgeons with many years of experience. We approach surgery with a great deal of humility and caution. Before surgery, there will be an attempt to explain exactly what our "game plan" is for your surgical procedure. In order for you to have as few surprises as possible, we will discuss all possibilities for your surgery in advance.

Clinical Staff

Other members of our clinical team include physician assistants and nurses.

The Physician Assistant

The Physician Assistant's training allows him to assist the doctor in the office and in the hospital, including surgery. They are in constant communication with the surgeons and the staff, and they are able to take responsibility for making sure that patient problems are addressed quickly and competently. PAs are knowledgeable about problems that can occur before and after surgery, and they may be the first person that would be called if a problem arises.

Nurses

Nurses are often the first link of communication to surgeons and PAs. They have been trained to recognize problems and to expedite solutions. NeuroCare Nurses are highly skilled in conducting admission histories, obtaining laboratory data and diagnostic test results, explaining surgical and conservative care treatments and diagnostic procedures. They serve as a contact between the patient and the physician to facilitate continuity of care.

The Patient's Role

The most frequent reason for surgery is pain. Since pain is a personal experience that cannot be shared with other people, even your doctor, we have always felt that the decision to have surgery should ultimately be yours. The surgeon's job is to teach the patient everything he knows about surgery, and the patient's job is to understand this and to decide if the impact of his problem on his life is such that surgery seems to be the best option. No surgery can be predicted to be 100% successful, and there is always the possibility of a complication that could produce an undesired outcome. This has to be factored into the decision-making process.

There are many things that our patients are encouraged to do to enhance the probability of a successful outcome from surgery. Some of these are:

1. Strengthen the muscles in your spine before surgery with physical therapy or a home exercise program.
2. Stop smoking.
3. Achieve optimal weight prior to surgery.
4. Evaluate the quality of your bones, and treat conditions such as osteoporosis.
5. Behavioral medicine intervention can help reduce depression and stress which are commonly found in patients who are living with chronic back pain.
6. Significantly cut down on pain medication prior to surgery in order to better tolerate the surgical experience.
7. Discontinue all non-steroidal anti-inflammatory medication a week or more before surgery, or as instructed by your doctor.
8. Give proper medical attention to other health problems such as diabetes, heart trouble, high blood pressure, etc.

At least 50% of the success from surgery is the contribution from the patient. Even the most perfectly performed surgery is not likely to help unless the patient's attitude is positive and the desire to get well is very strong.