Key Questions to Ask When Ordering instruments for assisted discectomy

Having spine surgery is a big decision, and it's in your best interest to ask relevant questions&#;so you know how to prepare, how to select a well-qualified surgeon, and what to expect both after the surgery and in the longer term.

You can find more information on our web, so please take a look.

Consider the following comprehensive list as a starting point to help guide you in your consultation with the surgeon.

Questions regarding your surgical treatment

This list focusses on your specific surgical procedure that was recommended by the surgeon. These questions will give you an idea of what the procedure will be like and what to expect in the short and long term.

1. What type of surgery are you recommending and why?

   See Back Surgery and Neck Surgery Overview

2. What is the source of the pain that is being addressed? How did you confirm this source?

   See Getting an Accurate Back Pain Diagnosis

3. Please explain the procedure in detail.
   The amount of information depends on your personal preference. Some patients want to know everything, others may prefer a brief description.

   View our Spine Surgery Videos

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4. How long will the surgery take?
5. Can it be done endoscopically or is an open surgery recommended?
6. What are the side effects, potential risks, and potential complications of the surgery?
7. Please explain the possible risks that may arise from my state of health and well-being.
   Patient-related risk factors like older age, smoking, being overweight, or having grade 3 spondylolisthesis, can affect the surgical outcome.
8. What if, during my surgery, you encounter a different spine issue than you expected?
9. Do I need to donate my own blood? If yes, why?
   For most types of back surgery, blood does not need to be donated ahead of time.
10. Do you perform the whole procedure? Will any students and/or other surgeons be doing any parts of the operation? If yes, who are they and what are their qualifications?
    Some surgeons only perform a small part of the operation while others carry out the entire procedure. If another surgeon is required (such as a vascular surgeon), their role is important, and it would be good to know their qualifications.
11. Who else will assist you in the surgery?
12. What are the long-term consequences of the proposed procedure?
    For example, will the operation ever need to be re-done? If it is a fusion, will it lead to degeneration in other levels of the spine?

    See Spine Fusion Risks and Complications

13. What are my nonsurgical options? How long will their effects last?
14. What is the natural course of my condition if it is not surgically addressed?

You may want to discuss your previous surgeries, medications, and injuries to make sure this procedure does not adversely affect your health.

Questions regarding your surgeon&#;s skills and qualifications

It is important to know if your surgeon is knowledgeable and qualified to perform your surgery. This list can help you understand your surgeon&#;s skills to perform your surgery.

15. How many times have you done this procedure?
    Experienced surgeons are typically better and would have encountered several types of spinal conditions. They will also have good knowledge of the modifications of different procedures that may be necessary in some cases.
16. Are you board-eligible or board-certified?
    Surgeons usually display their certificates on the wall.
17. Are you fellowship-trained in spine surgery?
    Fellowship training is preferable if the surgery is a fusion, artificial disc replacement, or other more extensive procedure.
18. If I want to get a second opinion, can you recommend a surgeon I should go to?
    The recommendation should typically be someone not in the same practice.

    See How and When to Get a Second Opinion Before Spine Surgery

19. Statistically, what is the success rate for this type of surgery? How many surgeries of this type have you done and what is your personal success rate?
20. Can I talk to other patients who have had a similar procedure?
    The patient will have to sign a HIPAA release form, but typically, happy patients want to share their success stories.

Any defensiveness on the part of the surgeon when you ask these types of questions may be a red flag. A surgeon with good results and appropriate qualifications will not be threatened by these questions and will respect your attention to these matters.

See How to Select a Spine Surgeon

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Questions about what to expect after the surgery

Knowledge about the recovery process after your surgery will help you understand your post-surgical phase and set expectations for the functionality of your spine in the future.

21. What degree of pain should I expect after the surgery and for how long?
22. How long is the hospital stay?
23. May a family member spend the night with me in the hospital?
24. How do you manage the pain in the hospital?
25. Which pain medications will I be sent home with? What are the possible side effects of these prescriptions?
    Some meds may cause side effects such as drowsiness or constipation.

    See Preventing Constipation After Back Surgery

26. Will you know before the surgery if I will need a back brace afterward? If so, will I be fitted for one before the procedure?

    Read more: Using a Back Brace for Lower Back Pain Relief

27. Will I need any other medical equipment (like a walker) when I go home? Should I get an adjustable bed or sleep downstairs?
28. Who can I call if I have questions after the surgery? What is the process of communication?
29. How often will I see you after my surgery?
30. What symptoms would warrant a call to your office?
31. What symptoms would warrant immediate medical attention?

    See When Back Pain May Be a Medical Emergency

32. What limitations will I have after surgery and for how long?
    You may have certain movement and/or activity restrictions.

    See Practical Advice for Recovering from Back Surgery

33. How long should I wait to bathe?
34. How long will I be out of work (or school)?
35. What kind of help will I need when I return home?
36. When can I drive again?
37. When can I resume normal (light) household chores?
38. What expectations do you have for my recovery?
39. When is it safe to resume sexual relations?

    See Back Pain and Sex

40. How soon after the surgery can I start physical therapy?

    Read more: Rehabilitation After Spine Surgery

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It is also good to ask relevant questions to your insurance provider regarding the costs that you will be responsible for and if any other payments are anticipated from you.

To make the best use of your time when talking with your surgeon, it may be a good idea to print this list and take it with you to your surgical discussion.

It is important to thoroughly understand your surgical procedure, risks, and benefits. If you decide to get a second opinion, be sure to carry all your medical records so that tests do not need to be repeated. When you are well-informed and confident about your surgeon and surgery, you will likely be more satisfied with your surgical outcome.

Learn more:

Postoperative Care for Spinal Fusion Surgery

ACDF Surgery Postoperative Care

Postoperative Care for Lumbar Microdiscectomy Surgery

Dr. Larry Parker is an orthopedic surgeon at the Spine Center at TOC in Huntsville, AL. Dr. Parker has specialized in spine surgery for more than 25 years. He has given several scientific presentations and published numerous papers in medical journals.

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This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

23 Jan

PONE-D-22-Survey research of patient&#;s preference on choosing microscopic or endoscopic spine surgery for lumbar discectomy.PLOS ONE

Dear Dr. Kraiwattanapong,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE&#;s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

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The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for giving me the chance to review the manuscript entitled &#;Survey research of patient&#;s preference on choosing microscopic or endoscopic spine surgery for lumbar discectomy&#;. This is a very interesting and useful study. The experiment was well designed. And the manuscript was well written. It could promote doctors getting a clearer idea of patients&#; preferences for surgical approaches.

1. As a spine surgeon, I think some patients are not suitable for ELD, whether such patients excluded from this study?

2. I think the author could include patients who underwent surgery for one year or more years in future studies. It can help to understand how the long-term outcomes of the two surgical methods influence patients' preferences.

3. The conclusion is too long, which should be shortened.

Reviewer #2: Dear respected authors. Congratulation for your work. Few remarks for the purpose of perfection I will mention:

*Line 39: most patients prefer ELD (patient preference]

Line 62: ELD had same outcome with less complications than MLD [scientific preference].

Therefore, you should add in the conclusion that ELD is preferred scientifically and by patient&#;s preference and no need to ask for patient&#;s opinion in future, as ELD is preferred whenever it is available and possible.

Line 22, 65: There is no clear evidence for how to select the procedures. Why? (You mention later in 61- 62, line 208, 221 [Although the treatment outcomes and complications were not significantly different, ELD can reduce tissue injuries and reduce hospitalization].

*Line 138: what is the value of including the marital status, residency and academic degree in the questionnaire of this study?

*Where are the patient information sheath? Like what is differences about wound size, time of surgery &#; between the two procedures in the information sheath. These information of course affect patient decision.

*Page 29, 30, 31: links: readers should read all informations of the subject in one file, not to follow a links. Please try to merge informations of the appendicular files with the main manuscript. It is difficult to publish this form of paper.

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Reviewer #1: No

Reviewer #2: Yes: Raed J. Chasib

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