Neck surgery requires incredible precision, skill, and expertise. Once you have decided to have neck surgery, the next step is to find the ideal neck pain surgeon. Before you sign the informed consent to have neck surgery, make sure you ask 10 important questions. Also make sure you get the right answers.
- What is my diagnosis (i.e., what is it that is causing my symptoms, exactly)?
If the surgeon does not know your specific diagnosis, there is no way to perform a specific surgical treatment. Remember that “nonspecific back pain” or “nonspecific neck pain” is actually a diagnosis, even if it does not sound like it. In these cases, conservative treatments are usually best, but back or neck surgery may be needed if conservative treatments fail.
- Have you completed a fellowship in spine surgery?
Only orthopedic surgeons or neurosurgeons should operate on the spine. Ideally, anyone performing neck surgery involving the cervical spine should have completed a fellowship in spine surgery. Otherwise, you are seeking care from someone who is less than a specialist in the field.
- What are my surgical options for treatment?
In many instances of neck pain, there is more than one surgical treatment option. Your neck surgeon should be able to discuss those options along with the risks associated with each. It is impossible for you to know the merits of each procedure, but you still should be able to understand why your spine surgeon is recommending a particular surgical treatment over the others (e.g., higher success rate, faster recovery time, lower complication rate, etc.)
- What are my nonsurgical options for treatment?
Just because you are meeting with a neck surgeon does not necessarily mean you have exhausted all of your conservative and semiconservative options. You may be a candidate for injections before you proceed to surgery. Anyone who has completed the spine surgery fellowship is well versed in both the surgical and nonsurgical options for the treatment of neck pain.
- How many times have you performed this neck surgery?
This fair question should be asked. You want to find a neck surgeon who has done a reasonable number of surgeries of the kind the surgeon is proposing. Unless the procedure is extremely new, any surgeon who has had a spine surgery fellowship has performed dozens of surgeries involving the spine of virtually every type.
- If I decide not to have neck surgery, what can I expect?
You always have options. Unfortunately with neck pain, sometimes your option is to simply adjust to a life with pain. Nevertheless, if you decide not to have the next surgery that is being proposed, your neck surgeon should be able to tell you what life will be like without neck surgery. He or she should also be able to tell you what life will be like after neck surgery. The former should not be too bleak and the latter should not be too rosy.
- Who will assist you in this neck surgery?
No surgeon performs surgery alone. At the very least, a scrub nurse coordinates instruments and supplies. Ask your neck surgeon if anyone will assist during surgery, especially a second surgeon. Also, inquire about the anesthesiologist. It is helpful to meet the anesthesiologist performed the procedure to discuss any medical issues you may be having.
- What is the success rate of the surgery overall and how does it compare to your success rate?
No surgery is 100% successful. You should ask your neck surgeon about the success rate for your particular surgery and the surgeon’s success rate. Those numbers should be reasonably close to one another.
- What are the main complications of the surgery and how often do they occur?
Make sure you are willing to risk the complications that may occur during surgery. As with most important decisions in life, every surgery is a calculated risk. Physicians follow the code of “first, do no harm” so if the risks outweigh the benefits, your surgeon will not perform the surgery. On the other hand, complications that occur a small percentage of the time may be unavoidable. You should know the possible complications of your surgery and be willing to take that risk before neck surgery.
- What should I expect during recovery from neck surgery?
Your neck surgeon (or surgical team) should be able to describe neck surgery in detail, including the recovery. You should know the estimated time it will take to recover, the physical therapy that is most likely to be involved, and when you will be able to return to normal activity.