The TRUTH. YOU the PATIENT have control over 5 of the risk factors associated with SPINE SURGERY:
1. SMOKING. Smoking is associated with poor healing of the wounds. From a very basic science perspective, smoking decreases the blood flow to areas secondary by causing constriction of your arteries. The lack of blood supply impedes healing of the wound. In terms of fusions, it is a well known inhibitor of its formation.
2. OBESITY. Having a Body Mass Index of over 35 is considered morbidly obese. Physicians have been accused of not being sensitive, or being judgmental when discussing obesity with patients. While it is a sensitive topic, there is no denying the truth. Having an elevated BMI puts you at risk for any surgery, both in the short term, and the long term. For SPINE SURGERY, obesity has been associated with poorer outcomes and satisfaction. I am not judging anyone. As a Physician, I advise everyone to keep their weight down, especially if you have spine pain, and have concerns for potential future spine surgery.
3. FITNESS. This seems to go hand in hand with OBESITY, but this is actually a different factor. You can be over weight, but still be relatively fitter. Studies have shown that people who are more active have better recoveries from most surgery. You do not need to be a marathon runner, or an olympic athlete to work on your fitness. A consensus recommendation is 2.5 hours of moderate exercise a week. That can be activities like walking, gardening, mowing your lawn, doubles tennis, etc. Before you say you do not have time, understand that there are 168 hours in a week. That 2.5 hours can make a significant difference to your overall health, and can improve your chances in case you have surgery.
4. NUTRITION. Yes, you can be OBESE, and have poor nutrition. A balanced diet, with complex carbohydrates, and proteins is necessary to maintain better blood sugar levels, and blood albumin levels. Several studies have demonstrated poorer outcomes with poor nutrition. While some argue that it may be too expensive to have an appropriate diet, the truth is there are many economical food items that allow you to digest healthy proteins, and carbohydrates. You can always find an excuse. If you want to give yourself the best chances, have a balanced diet, maintain your weight, while getting proper nutrition. Your surgical outcome depends on it.
5. ATTITUDE. People who are confident in their surgical decision will also take the appropriate steps to maximize the chance of a successful outcome. ATTITUDE ensures people will maximally control what is in their power. ATTITUDE means thoughtful exploration of the options, and once a decision is made, positively taking the steps to improve the outcome. At the same time, because of the proper steps initiated, and appropriate understanding achieved, the outcome, no matter what, if much more acceptable. YOUR ATTITUDE is essential to maximize your chances of a positive outcome.
This Blog will be hard for some to read. The reality is that YOU HAVE SOME CONTROL over your spine condition and treatment. YOU HAVE A SHARED RESPONSIBILITY over the outcome of you surgery. These factors are controllable, but take hard work and discipline. You cannot just rely solely on the medical team.
- Elgafy H, Hamilton R, Peters N, Paull D, Hassan A. Critical care of obese patients during and after spine surgery. World J Crit Care Med. 2016 Feb 4;5(1):83-8. PubMed PMID: 26855897