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Severe Stenosis - Doc advises surgery

Spine Health | Last Active: Jan 23 10:05pm | Replies (64)
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@kdks99

Thanks for your response. I know that no surgeon can commit to a specific outcome but I think it's reasonable to want a realistic assessment of possible outcomes. If I see one experienced surgeon at a major teaching hospital that recommends surgery and another equally credentialed surgeon who says no surgery how can i make an educated decision that, one way or another will impact me in such a profound way? I don't understand why information about the number of patients with comparable issues who experience an improvement, no improvement or deterioration is so elusive. My goal is utilizing evidence based medicine along with specific information regarding specific results from a specific surgeon. I don't expect predictions or guarantees but in my opinion, patients deserve all the available facts before arriving at a decision. When I ask a surgeon questions about how long are surgical patients are followed, how many require a second surgery, what is the best and worst outcomes of surgery, how often do they occur etc. there is resistance and I'm told as you said "role the dice". Back surgery is a big deal and I really don't know how to proceed without some data. I think patients have the right to all available information.

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Replies to "Thanks for your response. I know that no surgeon can commit to a specific outcome but..."
Jennifer, Volunteer Mentor | @jenniferhunter | Jan 15 11:22am

@kdks99 Instead of asking specifics and statistics of “how many” patients experience a particular result, it may make more sense to ask “why” an outcome occurs or “what” other health issues or patients not following medical advice contribute to a negative result. You could also ask how your condition may change over time without surgery. It may help to work with a physical therapist so you can ask these questions there as well. PT’s who have experience rehabbing surgical patients are a great source of information. You also need to have a mind body connection to be able to understand in 3 dimensions how your body works physically and what limits you. That may help in your decision.

There are too
many variables for surgeons to predict exactly what your experience will be and if they did that, it probably would set a precedent that could bring on a legal challenge from anyone who wants to complain.

Here is simple example not related to medicine. How many gallons of paint does it take to paint a house and can that be predicted exactly? It depends on coverage and square footage. Does everyone paint exactly the same way and same thickness? No. Using a roller vs a brush, which one absorbs and holds onto more paint causing a bit of waste? How does the weather affect the job? Did it rain and wash away paint that wasn’t dry? How does humidity or lack of it affect drying time and paint layer thickness? Did any paint get accidentally spilled?

It is impossible to predict exactly how much paint and time are required in this example. You can estimate it and when you don’t have enough to finish the job, you can go back to the store.

You have to trust yourself to make the best decision that you can. If you know why problems occur, you may know how to avoid them or to lessen your chances of it. Surgery is a compromise and it has a risk to benefit ratio. That is what the doctor is telling you with statistics. Ask how you can improve your chances to have a great outcome and what you can do to assist in that outcome. I think your surgeon will be more receptive to that question. They put their reputation at stake with every surgery and they don’t want a bad outcome for you or themselves.

In the end, it is your decision.

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