Spine Surgery

It’s NEVER a stupid question. Always ask.


40 Questions to Ask Your Surgeon Before Back Surgery

www.spine-health.com Stephanie Burke

Before you decide to have the surgery

1. What type of surgery are you recommending? Why?
2. What is the source of the pain that is being addressed? How do you know this?
Exploratory surgery is never done on the back.
3. Please explain the procedure in great detail.
The amount of information depends on your personal preferences. Some patients want to know everything, some not so much!
4. What are my non-surgical options?
5. What is the natural course of my condition if it is not surgically addressed?
6. What would you recommend if I was your friend, wife, sister, or daughter?
7. How long will the surgery take?
8. What are the side effects, potential risks, and potential complications?
9. Please explain the risks and how they relate to me personally.
For example, different risk factors like smoking, being overweight or having grade 3 spondylolisthesis, etc, will affect surgical outcomes.
10. What if, during my surgery, you encounter a different spine issue than you expected?
11. Do I need to donate my own blood? If yes, why?
For most types of back surgery, blood does not need to be donated ahead of time.
12. Do you perform the whole procedure? Will any students and/or other surgeons be doing any parts of the operation? If yes, who are they and what are their qualifications?
13. Who else will assist you in the operation? What are their background and qualifications?
14. What are the long-term consequences of the proposed procedure?
For example, will the operation ever need to be re-done? If it is a fusion, will it lead to degeneration at other levels of the spine? Questions about the surgeon
15. How many times have you done this procedure?
Generally, when it comes to surgery, “practice makes perfect,” so more experience is better. However, if the doctor is recommending something that is not often done, such as multi-level fusions, more experience would not necessarily be better.
16. Are you board eligible or board certified?
You can usually look on the wall and see a certificate.
17. Are you fellowship trained in spine surgery?
This is more important if the surgery is a fusion, artificial disc replacement, or other more extensive procedure.
18. If I want to get a second opinion, who would you recommend?
The recommendation should be someone not in the same practice.
19. Statistically, what is the success rate for this type of surgery? What is your personal success rate, and how many of this type of surgery have you done?
20. Can I talk to other patients who have had a similar procedure?
The patient will have to sign a HIPAA release form, but typically, happy patients want to share their success stories.

Any defensiveness on the part of the surgeon when you ask these types of questions may be a red flag. A surgeon with good results and appropriate qualifications will not be threatened by these types of questions and will respect your attention to these matters.

Questions about what to expect after the surgery

21. What kind of pain should I expect after the surgery and for how long?
22. How long is the hospital stay?
23. May a family member spend the night with me in the hospital?
24. How do you manage the pain in the hospital?
25. Which pain medications will I be sent home with? What are possible side effects of these prescriptions (e.g. constipation, drowsiness, etc.)?
26. Will you know before the surgery if I will need a back brace afterwards? If so, will I be fitted for one before the surgery?
27. Will I need any other medical equipment (like a walker) when I go home?
28. Who can I call if I have questions after the surgery? What is the process for communication?
29. How often will I see you after my surgery?
30. What symptoms would warrant a call to your office?
31. What symptoms would warrant immediate medical attention?
32. What limitations will I have after surgery and for how long?
33. How long should I wait to bathe?
34. How long will I be out of work? School?
35. What kind of help will I need when I return home?
36. When can I drive again?
37. When can I resume normal (light) household chores?
38. What expectations do you have for my recovery?
39. When is it safe to resume sexual relations?
40. How soon after the surgery can I start physical therapy?

One thing we pride ourselves on here at Blue Ridge Orthopaedic & Spine Center is our willingness to listen to you and answer all the questions you may have about a procedure. Back surgery is scary stuff and it’s not taken lightly, often it’s the last resort when treating the injury. Please do not hesitate to bring these, or any other questions to the table if
you are looking at having spine surgery. We welcome it.



Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. Both of our offices are equipped with in-office  radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton office at 540-347-9220 or our Gainesville office at 703-743-2814.

Is Minimally Invasive Spine Surgery ever an Option?

Is Minimally Invasive Spine Surgery ever an Option?

Article written by: Allison Walsh – spine-health.com

After months of conservative therapy, some spine patients may opt for spine surgery if their pain is uncontrolled or if they are unable to do their daily tasks, and if a surgeon can identify a spine lesion that is responsible for the pain.

Conservative vs Surgical Care for Lower Back Pain

spinal cord

Some surgical candidates worry that they will need a spine fusion, which is an invasive surgery requiring months of recuperation.

The good news is that some spine conditions can be treated with a minimally invasive surgery, like a discectomy.

Reasons you may need a spinal fusion

First, let’s take a look at the types of conditions that may need to be treated with a fusion.

A fusion surgery is designed to stop joint motions in the spine that are generating pain. This may happen as a result of:


For many patients, spinal fusion helps them get back on the road to leading a normal, pain-free life. But as stated above, the surgery is considered invasive and the recovery time can be up to a year long.

Spine Fusion Risks and Complications

Many patients who need spine surgery will find relief from less invasive surgical procedures known as microdiscectomy or a microdecompression.


Reasons you may need a microdiscectomy or microdecompression surgery

Sometimes nerves in the spine are compressed by a narrowing of the spinal canal, causing referred pain to radiate down the arms or legs. This pain is called radiculopathy. The narrowing of the spinal canal may be caused by a bone spur or by a herniated disc.


See herniated discs and bone spurs


A microdiscectomy or microdecompression spine surgery, considered a minimally invasive surgery, removes the small portion of the offending bone or disc, allowing the nerve to heal.

See also Microdiscectomy (Microdecompression) Spine Surgery

The majority of patients with only radiculopathy pain (in the absence of one of the conditions mentioned above as a reason for spine fusion) improve without fusion surgery.

Microdiscectomy is often done on an outpatient basis. Typically, the patient will have no restrictions on their activity immediately following the surgery, and the success rate is 90-95%.

Most back patients will never need surgery. If you do need spine surgery, it doesn’t necessarily mean you will need a spine fusion.


BRO-Logo-colorBlue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. Both of our offices are equipped with in-office
radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton office at 540-347-9220 or our Gainesville office at 703-743-2814.

56 Things to Do While Recovering from Surgery

This weekend is looking to be stellar, weather-wise, and if you can get outside and enjoy it, please do! However, if you’re recovering from back surgery, getting around might be a bit tough, so here are 56 things to do to help you pass the time, courtesy of spine-health.com. Remember though, staying sedentary for too long can have negative effects on everyone, especially those recovering, so unless instructed by a doctor to stay in bed, please make sure to get up and move around a bit.


Pure entertainment

  1. Discover new music from the Internet: Fill up your iPod from iTunes, or join Spotify and Pandora to discover thousands of new tunes.
  2. Search Spine-health.com for articles relating to your condition.
  1. Sharpen your thinking skills with online games from luminosity.com. You can sign up for the free version to see if you like it.
  2. Read a great classic: To Kill a Mocking Bird, A Catcher in the Rye, The Grapes of Wrath, The Old Man and the Sea, The Great Gatsby, The Call of the Wild, or War and Peace. Invest in a tablet reader such as a Nook, an eReader, or a Kindle to have instant access to almost any book in the world. If you have a smart phone or tablet, download the Kindle or iBooks app. Be sure to check Bookbub.com for free or discounted ebooks.
  3. Listen to books on CD or your iPod. Sometimes it’s easier to listen to a book than to read.
  4. Ask your kids to read to you.
  5. Play classic board games with your kids like Monopoly, Chess,Scrabble or Uno.
  6. Subscribe to Netflix, Amazon Videos, or Hulu to watch a season of a TV series that you had always wanted to see. Game of Thrones is an R-rated epic, Breaking Bad is intense and addicting, Chicago Fire is a drama with a fierce following. Or watch an older series, like 24Cheersor The Dick Van Dyke Show.
  7. Do crossword puzzles. Or try a numbers version of crosswords like Sudoku or kakuro puzzles. You can find free kakuro puzzles atKakuro.com and free Sodoku puzzles at Livewire Puzzles.
  8. Play the guitar (or learn to), or ask someone to play an instrument or sing for you.
  9. Watch old movies. These are great if you are feeling fuzzy from the pain medications . The classic old movies are slow-moving, so it’s easy to follow the plot. The library is a good source for free or very inexpensive rentals.
  10. Enjoy Xbox or Nintendo, Gameboy, Sony PSP, or any handheld electronic games. Try some of the new games on your smart phone or tablet. Download the Touch Arcade App to keep up to date with the hottest new games.
  11. Try Simon, a classic memory test game. It’s not too difficult, so it’s good if the pain medications are affecting your concentration. You can get a small version of it from Amazon.com.
  12. Get wrapped up in a long, complicated novel series. Here’s a great listto get you started.
  13. If you prefer, read the original magical book series, The Chronicles of Narnia by C.S. Lewis.
  14. Give yourself a manicure or a facial, or look through magazines to find a new hair style you’d like to try.
  15. Open up a Pinterest account and start pinning away. Pinterest allows you to create collections of your favorite ideas on different boards. VisitSpine-health’s boards while you’re at it.
  16. Read the entire New York Times – that will take at least a half a day!

Article continues below

Emotional care

  1. Sit out on your deck or porch for awhile each day and get some fresh air and sunshine. The Vitamin D from the sun will help get your endorphins flowing.
  2. Get free therapy online and make friends with other people who are in similar situations on theSpine-health.com Discussion Forum: “…finding this site and spending time here was a great help during recuperation – both in regard to having something to do but also for learning and understanding about our surgeries and recovery, and also being able to help and assist others here – that’s why I am still active here 7 months after surgery.”
  3. Start a blog: an online diary that allows you to chronicle your recovery and automatically notifies your network of friends and family each time you update it. WordPress.com offers free blog sites.
  4. E-mail a loved one who is having difficulty empathizing with your condition and invite him or her to view the Message Board so they can see what you and others in your condition have to go through.
  5. Connect with an old friend with whom you’ve lost touch. Try sending a card or letter to him or her via old fashioned mail. Or find your friend on Facebook and reconnect.
  6. Learn to meditate and practice, practice, practice. Meditation is great for reducing stress and producing an overall feeling of calm and well-being, all of which contributes to healing.
  7. Start to plan your rehabilitation by visiting Spine-health’s wellnesssections. Pick out exercises you think you’d like to try, and spend time mapping out your exercise plan.

Productive time

  1. Take this time to put all those old pictures in an album, or to turn your digital prints into real photos. Consider learning how to scrapbook or create online photo albums of all your digital prints with Shutterfly.com, Snapfish.com, or any other online photo service.
  2. Research and plan ahead for your next vacation.
  3. Become an expert on a specific subject: rent documentaries, read books, and use Google Scholar to do free online research on a certain subject. Ancient Greece? Bird watching? History of golf? Research and learn all about whatever interests you.
  4. Sort out the pile of mail, bills, catalogs etc.,that has been piling up on kitchen counter since before your surgery.
  5. Put your financials online with Quickbooks or a similar financial management program.
  6. Make some gifts the old fashioned way. Knit or crochet a baby blanket for someone who’s expecting a baby soon, needlepoint something to decorate the baby’s nursery, or make advance holiday gifts.
  7. Learn the almost-lost art of lace making.
  8. Learn to write left handed (or right handed, if you’re a lefty) to exercise a new part of your brain.
  9. Inventory all the stuff you want to get rid of around the house and garage, and sell it on eBay or Craigslist.
  10. Get started on that novel you’ve always wanted to write.
  11. Make a Honey-do (or handyman) list for all those odd jobs that need to get done around the house.
  12. Help build the online encyclopedia Wikipedia by editing or starting any topic where you have expertise.
  13. Learn origami and create beautiful origami gift boxes or figures.
  1. Learn calligraphy and make your handwritten notes gorgeous! This is especially valuable if you have horrible handwriting like mine…
  2. Create a list of recipes that are easy to prepare that you can make once you’re up and around but still recovering. Keep track of them online with Pinterest.
  3. Learn a new language using Rosetta Stone. Many libraries carry the Rosetta Stone program. Or, learn sign language.
  4. Research the health professionals you plan to see once you are ready to leave your home:massage therapists, physical therapists, personal trainers, etc.
  1. Order personalized stationery or address stamps or stickers. Or, if you send out an annual card, get to work designing it and updating your address list.

Feeling better by doing good

  1. Every day write a short thank you (or love note) to the person who is caring for you and put it in the same place for them to find each day.
  2. Write thank you notes to everyone in the hospital who was helpful to you. Go on the hospital’s social media sites and comment on the positive experiences you had.
  3. Help a homeless animal find a home by sharing their stories and pictures from rescue groups on Facebook. Start here.
  4. Pray in your own way. Research new prayers and devotionals.
  5. Read online verses from the Bible about healing and related topics.
  6. E-mail thank you notes to all the websites you found especially helpful (hint, hint!)…it makes all the hard work worth it! Contact us.
  7. Anytime you reach out to help someone else in need, you will feel less lonely and less depressed. Volunteer with an organization that allows you to call and talk to people who are lonely, such as people in nursing homes or people confined to their house.
  1. If you don’t yet have a cause that you’re passionate about, research one online (start here) and make a plan to start donating your time and energy to something you care about once you can get around.
  2. Be an excellent host or hostess. Send out invitations to your friends and family, schedule visits, greet your visitors enthusiastically even when you’re in pain, and encourage them to talk about themselves and their lives. It will go a long way to help take your mind off your situation, and will make it a pleasant visit all around.

Getting mobile again

  1. If you can’t walk much yet, have someone drive you to Wal-Mart or Target and ride one of the scooters.
  2. Schedule appointments with the professionals you researched from #42. Put the appointments in your calendar, and mentally prepare for them.
  3. Just walk, walk, walk. Try to gradually work up to 10,000 steps a day.
  • See Exercise Walking for Better Back Health
  • Get comfortable shoes for walking that are easy to get on and off. Crocs are a favorite – they’re lightweight, slip on so you don’t have to bend over to get them on or off, and have some traction to help avoid slipping.
  • Walk on a treadmill and set a progressive goal (e.g. go for 2 minutes longer each day) that is OK’d by your doctor. Chart your progress each day so you have a visual confirmation of how far you’ve come!
  1. Sign up for a water therapy – it’s very gentle on your back, as the water supports you while you exercise and prevents any jarring motion.

Of course, check with your doctor first before doing any of the above. Many of these ideas do require a laptop and Internet access. If you don’t have a laptop, you can buy an inexpensive one (starting at $600) or try to borrow one from a friend or family member. Wireless Internet access is a good idea so you can access the Internet from your bed, a recliner, or wherever you’re most comfortable. Courtesy of spine-health.com.


Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions.  For your convenience, both our Warrenton and Gainesville offices are equipped with in-office radiology departments.  Not only does this facilitate rapid diagnosis but it’s also convenient for patients who may be experiencing pain or disability at the time of their visit.

To schedule an appointment with one of our board-certified/ fellowship trained physicians, call our Warrenton office at 540.347.9220, or our
Gainesville office at 703.743.2814, or, click here to make an appointment.  Don’t forget to visit us at www.broava.com for a complete list of all comprehensive musculoskeletal services offered at Blue Ridge Orthopaedic & Spine Center.

Get to Know Your Back!



If we didn’t have spines, we wouldn’t be able to stand, bend, twist, or move with any flexibility.  In this article from Krames Staywell you will get to know and understand your back.

The spine has 33 bones known as vertebrae, which provides support and helps protect the spinal cord.  The spinal cord transmits messages from the brain to the body and then from the body back to the brain.

The spine is broken down as follows:

  • The cervical spine is the first 7 of 33 vertebrae and provides head support.  Find yours by touching the upper back and feeling the bony protrusions.
  • The thoracic spine is composed of 12 thoracic vertebrae and helps to keep your organs in your chest and acts as an anchor to the ribs.
  • The lumbar spine is located in the lower back and is composed of 5 vertebrae.  The lower back provides the most support and sees the most action, which is why so many of us suffer with lower back pain.
  • The sacrum and the coccyx (tailbone) are located at the bottom of the spine.  The sacrum is created before we are born by 5 naturally fused vertebrae, and joins the spine to the pelvis and the lower half of the skeleton.  At the end of the spinal column is the coccyx (tailbone).

In the middle of each vertebra is a sponge like cushion called a disk.  Disks are responsible for absorbing shock from body movement.  In addition, they cushion all the spinal bones and help keep the back fit.

Your spine is reinforced with strong back muscles which aid in holding the vertebrae and disks in proper alignment.  Lastly, strong abdominal, hip, and leg muscles help to reduce strain on your back.

Blue Ridge Orthopaedic & Spine Center resolves everyday aches and pains.  Poor posture, trauma, improper lifting, and aging – all of these factors can injure your spine and cause pain.  Whether caused by an injury or the normal wear and tear of time, spine-related ailments require the best care available.

Blue Ridge Orthopaedic & Spine Center’s spine care specialists are board certified/fellowship trained and have extensive experience treating nearly every kind of condition, including spinal trauma of the neck and back, spine surgery, tumors and infections, spinal stenosis, degenerative disc disease, herniated discs, and adult degenerative conditions of the neck and back.  Call us today @ 540.347.9220 (Warrenton office) or 703.743.2814 (Gainesville office) if you have questions, or you are experiencing neck/back pain.  We can help!  Please visit www.broava.com for more information on all of the comprehensive services offered by Blue Ridge Orthopaedic & Spine Center.

Spine or Neck Surgery?



Is surgery for back or neck pain right for you?  The answer – sometimes.  Is it reasonable for you to consider spine or neck surgery if your pain has not diminished after several months of non-surgical treatment, if your pain does not respond to medications, or you are unable to complete every day activities?  You bet it is!

Don’t worry.  There is a wide array of surgery options.  Some are minimally invasive procedures that allow for a quick recovery, while other types of surgeries are more extensive and have a much longer recovery time.

The Spine Center team at Blue Ridge Orthopaedic & Spine Center offers a range of surgical spine treatments, including:

  • Kyphoplasty/vertebroplasty
  • Interspinous process decompression (X-STOP, ILIF)
  • Limited approach discectomy
  • Spinal stenosis surgery
  • Anterior cervical discectomy and fusion
  • Posterior cervical laminectomy
  • Lumbar interbody fusion (PLIF,TLIF, XLIF)

The board certified spine specialists at Blue Ridge Orhopaedic & Spine Center offer a wide range of minimally invasive testing to diagnose and determine which treatment option is best for you.  To schedule an appointment with one of our spine specialists at Blue Ridge Orthopaedic & Spine Center, please call 540.347.9220 (Warrenton location) or 703.743.2814 (Gainesville location) or visit www.broava.com for more information.

Our GOAL – Get YOU back to GOOD HEALTH.