Why Spine Surgery in Tampa FL? Because we are in Florida, with a large senior population. This population experiences significant episodes of back pain secondary to the natural aging process. We physicians gain a great amount of expertise in managing these problems. Because of this experience, the hospitals and facilities also gain significant expertise in handling many spine ailments.
Also, Florida, in general, has a history of delivering the latest advances in many of the medical fields due to our traditionally older population. With that volume of healthcare delivery, many groups develop niche areas, and market to the general population.
Spine Surgery in Tampa FL is no different. There are multiple spine surgery centers in the Tampa Bay area. Also, there are a significant number of spine surgeons, who deliver excellent spine surgery care in their own individual offices.
As a patient, it may sometimes be difficult to decide which facility, or which surgeon to choose. But, there are certain questions that might help you decide.
1. Is the surgeon board certified? It is now rare, but sometimes, a surgeon may not have met the critierion to be Board Certified. Spine surgery is performed by orthopaedic surgeons and neurosurgeons. Please ask if the surgeon is Board Certified by the American Board of Orthopaedic Surgeons, or the American Association of Neurological Surgeons.
2. Has the surgeon been fellowship trained? Although most orthopaedic surgeons and neurosurgeons have basis spine surgery training in their residencies, many surgeons pursue advance studies or Fellowships in Spinal Surgery. Although not necessary to perform spine surgery in private practice, often times, it indicates a desire to specialize in treating spine patients. Please inquired about the surgeon’s training and specialization.
3. How long has the surgeon been in practice? Every surgeon goes through stages in their career. After finishing residency and fellowship, new surgeons often are the ones who take care of many of the emergency patients as they are more available, and often they are required to take on-call responsibilities to their respective hospitals. In that process, new surgeons rapidly develop skills, and confidence. This “paying my dues” process is necessary to develop experience. Most physicians have excellent training and provide excellent care to their patients. But still, during the first 4-7 years, each surgeon develops their own style of treatment, and during that time, most surgeons will find a niche or area that more appeals to them. Though competent to care for most situations, surgeons may begin the process of specialization. For spinal surgery, that process is helpful to develop skills in making decisions about who will have a good outcome, as well as the pure technical exercise in performing the surgery. It may come as a surprise to many patients, but the actual technical skill from one surgeon to the next is often very similar. The difference in the outcome is usually dependent on the diagnostic skills, and the surgeon’s decision making process in offering surgery.
4. How aggressive is the surgeon? As stated in the previous paragraph, the actual technical skill from one surgeon from another is often similar. But, each surgeon must decide what is an acceptable ratio of good outcomes to bad outcomes for that surgeon.
This concept requires some explanation. For every surgery, often times there are criteria to predict good outcome. Factors that predict a good outcome for patients include good overall health for the patient. Normal body weight. Physical examination findings that are very specific to the proposed surgery. Diagnostic studies that are consistent with the proposed surgery. Failure of appropriate non surgical care. Targeted and specific findings do predict a good outcome.
The following patient is an example of a patient with an excellent predicted outcome for surgery. The patient is a healthy 35 year old , normal weight person, with a large left sided single disk herniation. The disk herniation causes specific corresponding areas of numbness, weakness and reflex changes. After failing non surgical options, the patient is an excellent candidate for surgery, with a 95% predicted successful outocme.
Contrast that situation with a 75 year old obese person with significant heart disease. This patient also has four different areas of disk herniations or stenosis and requires a large fusion operation as well as removal of the disks and bone spurs. This patient also has been using chronic narcotic medications, with concern for addiction. This person is also a heavy smoker. Surgery is very risky for this person, and prediction of success is probably 50-50. 50 percent better…..50 percent worse.
In the second scenario, some surgeons will decide not to offer surgery, while others will accept a 50-50 chance. The surgeons who do not operate, are considered conservative, the surgeon that offers the surgery is considered aggressive.
The problem with the too conservative surgeon is that an opportunity to help a patient with surgery may not be offered. But for the patients that do get surgery offered by a more conservative surgeon, usually there is a high predicted rated of successful outcome.
With the more aggressive surgeon, should surgery be offered, and if the outcome is bad, no one is happy. In my experience, no one will thank the surgeon for trying if the outcome is bad. In the second scenario, you are either a Hero or a Zero. It is great when things work out. It is horrible if it does not. In the mind of the aggressive surgeon, at least the patient was offered a chance. As surgeon’s gain more experience, they tend to become more conservative.
Please discuss the the predicted chance for success if you are having surgery. Then, consider a second opinion to see if another surgeon has the same prediction for success. In the end, you must feel comfortable with your surgeon. You must feel confident of the good outcome. And you must be prepared for any outcome.