Great advances have been made in the treatment of spinal conditions over the last three decades.  Utilizing modern techniques, many patients with neck or arm pain, back or leg pain, and spinal deformity may benefit from spinal surgery.  

Only a fellowship-trained spinal surgeon can reliably determine if a patient would benefit from spine surgery.  The decision to potentially pursue surgery should be made only after careful examination of the patient, review of imaging tests, discussion of the patient's goals, and thorough conversation about the risks and benefits of spinal surgery.

Are there alternative forms of treatment for these conditions before surgery?

Spinal surgery is truly a last resort.  Fortunately, there are many treatments available to patients that can help treat pain without surgical intervention.  In my practice, nearly all patients will attempt non-operative management with physical therapy, medications, injection treatment, bracing, or other interventions prior to considering surgery.  Surgery should be reserved for individuals who cannot be treated with conservative measures.

What are the benefits of surgery over alternative treatments?

There are certain patients who unfortunately will require spine surgery to improve pain to resume regular activities.  In my practice, patients with debilitating spinal deformity, for example, can really only be treated with surgery. This is because physical therapy and bracing are ineffective for severe spinal deformities.  There are other patients who have very severe nerve compression and no conservative treatment can truly alleviate symptoms long-term.  A careful discussion between the surgeon and patient is necessary to determine if and when to pursue spine surgery.

New robotic option for spine surgery 

The Lifespan Orthopedics Institute at The Miriam Hospital has acquired the Medtronic Mazor X Stealth Edition robotic guidance platform. It is the first in southern New England and available at only a handful of spine centers in the United States.

The Mazor X Stealth system is the latest in robotic technology for surgeons. It combines 3D surgical planning software, robotic guidance with greater control and exceptional precision, and stealth navigation.

Its robotics and radiation-reducing techniques mean the safest, most cutting-edge spinal surgeries for our patients. For patients, its benefits include less exposure to radiation, reduced risk of complications, smaller incisions, less pain following surgery, a shorter hospital stay and faster recovery. You can learn more about the Mazor X Stealth here.  

What are the signs that a patient might be ready for surgery?

Patients may know when they need surgery. When the patient is affected every day by the spinal condition and is not able to pursue or perform normal activities on a daily basis, then surgery may be indicated.  If other measures have been taken but are not adequately controlling pain, then a spinal surgery may be in order.

Are there things a patient can do to improve the outcome from surgery?

We carefully prepare all patients for surgery. We hold a thorough discussion and educational session with each of our patients to discuss the strategies to optimize their outcome.  We do a pre-hab (similar to rehab) program to help patients get stronger before surgery, and we work with their physicians to ensure they are medically ready.

Can you prevent spine conditions?

Unfortunately, most patients with spinal conditions suffer spinal stenosis, disc herniations, disc degeneration, or deformity, at no fault of their own.  With that being said, the best thing we can all do is to opt for a healthy lifestyle with adequate exercise, maintain a healthy weight, and avoid smoking.

Fortunately, even for patients who have developed severe spinal conditions, we have excellent and safe surgical options which can provide long-lasting results.  Surgery performed by the right surgeon yields reliably positive outcomes with a very low complication rate.  

I advise all patients to do research on the procedure they are having and also the surgeon who will be performing it.  Make sure that you are comfortable with the surgeon and that you have an excellent relationship with both the surgeon and their office staff.

If you are having issues with your spine, visit our website to learn how we can help you.

Alan H. Daniels, MD

Alan H. Daniels, MD, is a board-certified spine surgeon who specializes in adult spinal deformity and other complex spinal disorders. He serves as chief of spine for the Orthopedic Department at Rhode Island Hospital and The Miriam Hospital, part of the Lifespan Orthopedic Institute. He is also director of spine surgery research, an associate professor at The Warren Alpert Medical School of Brown University, and co-director of the Brown Spine Surgery Fellowship.