Essential Preoperative Steps for Successful Spine Surgery

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• Medical Second Opinion for Spine Surgery
• Pre-Surgery Patient Education Program
• Physical Preparation and Therapy Before Surgery
• Smoking Cessation Before Spinal Surgery
• Lifestyle Modifications for Surgery
• Full Transcript

Medical Second Opinion for Spine Surgery

Dr. Eric Woodard, MD, strongly recommends a medical second opinion before any spine surgery. He advises that there should be a consensus among at least two or three experienced senior spine surgeons regarding the indications and the intended procedure. This process confirms that surgery is the correct choice. It ensures the decision is based on clinical conditions and symptoms, not just radiographic findings like an MRI.

A medical second opinion provides patients with confidence in their treatment path. Dr. Eric Woodard, MD, notes that three key elements must align for surgery to be the right option. The patient's clinical symptoms must match the MRI findings. There must also have been a failure of non-surgical treatments first.

Pre-Surgery Patient Education Program

Dr. Eric Woodard, MD, champions a robust preoperative education program for spine surgery patients. This program, often run by nursing staff, covers anatomy, the intended surgical procedure, and the instruments that will be used. Patients learn what to expect right before the procedure, in the operating room, and during the postoperative period.

This comprehensive education goes a long way in relieving the unknowns and anxieties associated with surgery. A well-informed patient is less anxious, which can positively impact the overall clinical outcome. Dr. Anton Titov, MD, and Dr. Woodard agree that understanding the entire experience is paramount for patient preparedness.

Physical Preparation and Therapy Before Surgery

Dr. Eric Woodard, MD, advises patients to get into the best physical shape possible before spine surgery. He engages his patients in pre-operative physical therapy to maximize their flexibility and overall fitness. This preparation helps the body withstand the physiological stress of surgery and recovery, similar to training for a sporting event.

Improving flexibility is particularly important. Dr. Eric Woodard, MD, explains that more flexible joints can facilitate movement after surgery when a patient is experiencing surgical pain. This enhanced mobility allows for more effective participation in crucial post-operative care and physical therapy, leading to a smoother recovery.

Smoking Cessation Before Spinal Surgery

Dr. Eric Woodard, MD, identifies smoking as a major negative factor in spine surgery outcomes. Nicotine has a specific toxic effect on bone and severely impairs bone healing. This significantly increases the risk of a nonunion, where the spinal fusion fails to heal properly. Smokers also have a higher baseline risk of osteoporosis and degenerative disc disease.

Beyond bone healing, smoking poses serious systemic risks. It increases the risk of cardiac events during anesthesia and complicates lung function, raising the chance of postoperative pneumonia. Dr. Woodard's protocol requires patients to be nicotine-free for at least three months prior to surgery and for six months afterwards, especially for spinal fusion procedures.

Lifestyle Modifications for Surgery

Lifestyle modifications are a critical component of preparing for spine surgery. The primary focus is on smoking cessation and physical prehabilitation. Dr. Eric Woodard, MD, stresses that these changes are not optional but essential for a successful outcome. Improving core strength and overall stamina helps patients better endure the operation and the rehabilitation process.

These proactive steps directly contribute to a faster and less painful recovery. By taking control of their health before surgery, patients actively participate in their own success. Dr. Anton Titov, MD, highlights that this patient-centered approach is key to modern surgical preparation.

Full Transcript

Dr. Anton Titov, MD: How to prepare for spine surgery? Leading Boston-based spine surgeon shares tips for preparing for a surgical operation, not just for spine surgery. Why is a medical second opinion important for anyone considering undergoing any type of surgery? How to get ready for a surgical operation if surgery is indeed required? How can preparing for surgery correctly improve clinical outcome?

How to prepare for spine surgery? How to prepare for spinal surgery? Video interview with a leading expert in spine surgery. Preparation before back surgery is important. You should get a medical second opinion to confirm that surgery is indeed required. How to prepare for spine surgery is important for patients to know.

A medical second opinion confirms that the degenerative spine disease diagnosis is correct and complete. A medical second opinion also helps to choose the best treatment method for herniated disc or spinal stenosis. Seek a medical second opinion on back pain and be confident that your treatment is correct.

The surgeon should explain to every patient how to prepare for spine surgery. Patients should learn all about the surgical procedure they will have. Patients should ask about what happens right before the procedure. Patients learn what happens in the operating room and what happens postoperatively.

A well-informed patient has less anxiety before a surgical operation. This improves clinical outcomes. Preparing for lumbar spinal fusion includes cessation of smoking. Smoking is a very negative factor in surgical clinical outcomes. Smoking also has a specific toxic effect on bone healing.

Key things you need to know about preparing for surgery are education and improvement in your stamina and flexibility. The best is to start physical therapy before surgery. Preparing for low back surgery well makes recovery faster and less painful for the patient. Knowing how to prepare for spine surgery is a crucial factor in spine surgery success.

How to prepare for spine surgery? Medical second opinion for spine surgery.

Dr. Anton Titov, MD: We spoke a lot about various conditions that require spinal surgery. Sometimes a surgical operation is necessary. What is the best way to prepare for spinal surgery?

Dr. Eric Woodard, MD: First of all, learn as much as you can about the surgery. I strongly recommend second opinions. There should be consensus in the indications and the intended procedure among at least two, sometimes even three, experienced senior spine surgeons. A medical second opinion gives you a lot of confidence that you are making the right decision. That is first and foremost.

Dr. Anton Titov, MD: Importantly, it allows a person to be treated because of the clinical conditions, not because of a radiographic finding, as you mentioned earlier in our conversation.

Dr. Eric Woodard, MD: No question about it. The radiographic results and findings on MRI of the spine have to match the clinical symptoms. But there also has to be a failure of non-surgical treatments. Those three elements go into the ultimate decision to pursue surgery.

Once you have agreed with your surgeon and your medical second opinion that surgery is probably the best option for you, preparation and education are paramount. For instance, here we have a very robust pre-spine surgery education program. The nursing staff runs this patient education program.

Patients learn a lot about the anatomy and about the intended procedure. Patients see some of the instruments that are going to be used in their spine. Patients talk about what's going to happen right before the procedure. Patients learn what happens in the operating room and what happens postoperatively.

Patients learn what the expectations for the entire experience are going to be. That goes a long way to relieving a lot of the unknowns. It relieves a lot of the anxieties that are associated with any surgery, not just spinal surgery.

Secondly, the other big factor we champion pre-operatively is to try and get the patient in the best shape of their life. Sometimes they possibly can get into better shape. Now there are limitations to this, because the reason patients are having spinal surgery is typically pain or weakness.

But if you think about what happens physiologically to the body just from surgery and all the after-care, this is similar to a sporting event or running a marathon.

Dr. Anton Titov, MD: You have to prepare.

Dr. Eric Woodard, MD: I try to engage my patients into physical therapy pre-operatively. This helps to maximize their flexibility and their fitness. It helps to have them glide through surgery in the best possible way.

Dr. Anton Titov, MD: What kind of lifestyle modifications do you recommend to your patients prior to surgery and after the surgery?

Dr. Eric Woodard, MD: Prior to the surgery, as I said, flexibility is probably most important. I mean, we all like a strong body core. It is essentially a strong abdominal region. But flexibility can go a long way toward facilitating movement afterwards, when you have some surgical pain.

Sometimes if your joints are a little more flexible, it facilitates your ability to move after a surgical operation. It helps your ability to participate more effectively in the post-operative care.

Dr. Anton Titov, MD: There is a big problem with patients smoking, especially men in the age group and demographics that might require spinal surgery. Smoking negatively affects many physiological processes and tissue repair. How does smoking affect the process of spinal surgery?

Dr. Eric Woodard, MD: Absolutely. Smoking on a number of fronts is a real challenge. Smoking is a real negative factor in overall clinical outcomes. First, there are just negative physiologic aspects of smoking. Smoking puts you at high risk for heart disease and having a cardiac event during anesthesia.

Smoking makes anesthesia more difficult because of the direct effects on lungs. Smoking increases secretions and your risk for pneumonia postoperatively. But the nicotine has a very specific toxic effect on bone and on bone healing.

People who are cigarette smokers typically have a higher degree of arthritis or degenerative disc disease to begin with. Smoking causes degenerative spine disease to begin with. Number two, smokers clearly have a higher risk of bone mineral loss.

Smoking leads to osteopenia and osteoporosis, especially in the cervical spine in females. Then the other big problem with nicotine is its negative effect on the ability to form new bone. When we are fusing the spine, the effective failure of fusion, called a nonunion, is significantly higher in folks who are using nicotine products than in those who are not.

Dr. Anton Titov, MD: Patients shouldn't smoke in general, but in particular, they should quit before any kind of spine surgery.

Dr. Eric Woodard, MD: We ask patients to be nicotine-free for at least three months prior to spinal surgery. We also ask them to stay away from smoking for at least six months after a surgical operation, especially if we are performing a spinal fusion surgery, fusion of vertebral bodies.

Dr. Anton Titov, MD: How to prepare for spine surgery? Video interview with a leading expert in spine surgery. Why is a medical second opinion important? How to recover faster after surgery?