Demystifying spine surgery: how shared decision-making improves your experience

It’s common to feel overwhelmed, uncertain or even fearful the first time you meet with a spine surgeon. Many people hear common myths that spine surgeries are ineffective or highly risky. For Andrew Mo, MD, demystifying spine surgery is a big part of your first visit.

“I always tell patients that they don’t have to have spine surgery,” Dr. Mo explains. “I’m not here to push a procedure on someone.”

Instead, Dr. Mo explains what surgery can accomplish, and what might happen if you don’t have surgery. You and your surgeon weigh these factors and decide on the right path together.

What is shared decision-making in healthcare?

Shared decision-making is a collaborative process where you and your doctor work together to make care decisions. Together, you consider multiple factors, including:

• Benefits and risks of each treatment option
• Family and caregiver support
• The doctor’s expertise, experience and recommendations
• Your goals and preferences
• Your overall health

Your provider may advise which treatment they believe will be most effective. However, the final choice is yours.

“I don’t offer surgery unless there’s a clear benefit to it,” says Dr. Mo. “But at the end of the day, the only thing that can shift a patient from point A (nonsurgical treatments) to point B (spine surgery) is the patient making that decision.”

Understanding spine surgery options and risks

Many nonoperative spine treatments, such as physical therapy and medications, are highly effective for reducing pain. Some people find that nonsurgical treatments offer relief for many years.

But nonsurgical treatments don’t cure underlying damage. Some people have severe spine damage that won’t improve with nonoperative approaches. Although surgery is much safer and more effective than it was in years past, there’s no such thing as a risk-free surgery, something Dr. Mo clarifies is important for patients to understand. “But if I didn’t believe in surgery as a viable treatment option, I wouldn’t be in this job,” he says.

Advanced techniques lead to better outcomes

Decades ago, neck surgery was extremely painful, involved days of immobilization with a neck brace, and boasted a success rate of only about 60%. Advancements in both technology and surgical techniques have drastically changed these outcomes.

Today, people return home the day of or day after neck surgery, they’re mobile immediately, driving within a week, and back to usual activities in about two months. The first-time success rate is around 95%.

Finding the right approach to spine surgery

Dr. Mo notes that many patients express concern around the need for future spine surgeries. In these cases, he uses analogies, images and 3D models to help you understand why some people get additional surgeries later on.

Imagine that the discs in your spine are like the four tires of a car. Two tires might be completely worn out, while the other two are moderately worn. One mechanic might recommend replacing only the two most damaged tires. Another might advise replacing all four at once.

“Replacing only two doesn’t prevent the other two from wearing out eventually,” Dr. Mo explains. You might decide to replace all four right away to avoid doing it later, or you may decide to wait. “When I operate, I want to find the approach that will last you the rest of your life, if possible.”

This approach is especially important for patients in their 70s and 80s who want to remain active. Dr. Mo says that being “too old for surgery” is another common misconception. Many of today’s techniques allow patients in their 70s and older to get spine surgery that improves their quality of life, for the rest of their life.

Treating patients like family

After their first visit, Dr. Mo shares that many of his patients say they feel like they’re being talked to rather than talked at. Some of this impression has to do with how much time he takes to ensure you fully understand what’s going on in your body and what you can do about it.

The other part has to do with Dr. Mo’s philosophy of care. “I think it’s vitally important to treat every patient like I would a family member,” Dr. Mo says. “That means I’m giving advice to someone I want the best for. Spine surgery is significant, but it doesn’t have to be scary.”

Learn more about spine surgery at Inova or call 571-472-6464 to schedule an appointment.