"I'd never get my back operated on!"

"My neighbor, Joe Blow, had spine surgery and he was worse after the surgery. I'd never have my back operated on!"

I hope you never need it, but I had my back operated on because of excruciating leg pain secondary to a herniated disc. It was one of the best decisions I ever made. Most, not all, of my spine surgery patients say the same thing. This is not to suggest surgery should be the first choice, but don't worry about Joe Blow.

People do get worse after spine surgery. Why? Several common reasons:

First, they probably should never have been operated on in the first place. When surgeons stretch the appropriate indications for a procedure to "try" to help a patient who is often begging (yes many patients request spine surgery) for a procedure, the result is failure.

Second, if you smoke, are hurt on the job or in a motor vehicle accident, have psychological issues such as depression, anxiety or bipolar disease, there is little chance you will be improved with spine surgery.

Third, if your pain pattern, neurological deficit, and imaging studies do not all match, you will not get a good surgical response.

Fourth, if you have had years and years of pain or 2, 3, 4 or more previous spine operations, the next one won't help you

Fifth, if you are addicted to narcotic medications, you will not be helped with spine surgery.

Sixth, if you see three or more spine surgeons that say you shouldn't be operated on, and you let the fourth surgeon do the procedure, you will not be helped.

Spine surgery should not be the first nor the last option for your pain. Make sure your spine surgeon is Board Certified in Neurosurgery or Orthopaedic Surgery. Thoroughly discuss your procedure and options with your surgeon. And make sure your pain isn't coming from some other ailment like arthritis of the spine or hip, diabetes affecting the nerves, or other reasons that only well qualified doctors can eliminate as causes.