It is rare for a patient suffering from spine problem to accept the need of surgery right-away. A spine specialist will recommend surgery only if he/ she feels that patient’s symptoms are coming from a specific problem in spine, and there is an effective treatment available for the problem which will cure the patient’s symptoms.
There are several reasons for a patient to not accept surgery as a treatment option. A patient suffering from any kind of medical problem would like to have his disease treated by non-surgical/ medical means. This is a natural tendency. Surgery is a last resort and it is difficult for the patient himself/ herself to know when is it correct to resort to surgical option. Patient will always ask for alternative options, and rightly so.
Though majority of the patients’ symptoms get better with medicines and physiotherapy, there are some patients who do not get better with medical treatment or get worse during the course of the treatment. These patients are the ideal candidate for spine surgery as long as there is a well-defined pathology in spine, and a well-proven and successful treatment option is available for that pathology.
Additionally, patients are not certain whether even after undergoing surgical treatment there symptoms will get better. This comes primarily from what they have heard from their relatives/ friends who have some bad experience from spine surgery in the past. Not only this, patients are often scared that symptoms should not worsen after the surgery. Majority of these fear are baseless and are based on previous bad results or poor understanding/ expectation from spine surgery.
Spine surgery in the current era is very safe and effective with excellent results. This is due to proper diagnosis available now a days due to better understanding of the spinal problems and availability of latest diagnostic methods (e.g. MRI). An immense improvement in surgical techniques and availability of advanced instruments/ equipment (minimally invasive surgery/ microscope etc.) has made surgeries very safe and effective.
Another biggest concern of patients is possibility of recurrence of symptoms. A patient who undergoes surgery wants that to be his last surgery. However, as we know spine is a moving part of the body which provides flexibility to back and neck because of movement between nearby vertebrae. This movement, body weight and progressive wear and tear of the body with increasing age can lead to recurrence of symptoms. This can happen to any patient; however, it is more common in patients who are overweight, who are in heavy labor activities, and patients who do not follow usual precautions need to be taken after the surgery. Even if the symptoms recur, an effective treatment is available for almost all recurrent symptoms.
Monetary issues always play a role, especially in the countries where cost of the healthcare/ surgery is borne by the patients themselves. In these scenario patients would always be concerned that there should not arise a need of any further surgeries. Spine surgeries being expensive, possible need of multiple surgeries will really deter the patient to undergo spine surgery.