As a practicing spine surgeon, I can attest to the fact that the majority of the patients I see struggle to find positive information about successful spinal fusion surgeries. I can’t remember how many times patients will say something like, “You know what they say? Never let them operate on your back.” When I reply, “Who is ‘they’?” the patients usually mention a friend, neighbor, someone in line at the coffee shop, or sometimes even their primary doctor. Clearly, spine surgery has a reputation problem, and those of us who practice the art have not done a great job of conveying how things have changed for the better. Until now…
Many patients are driven away from surgery by fear. Many are discouraged by a lack of tangible success stories. Over my 20 years in spine surgery I have asked thousands of patients what drives your fears, and how can we assess the objective data to help you make intelligent decisions? The goal of this article is to address why many patients harbor negative impressions of spine surgery (compared to knee or hip surgeries, for example) and look at some of the facts that reflect modern spine surgery results.

What Drives Patients’ Fears?
Patients are more comfortable considering surgeries on their shoulders or knees as they tend to know more patients who have had these, compared to spine surgeries. Being a bit more afraid of a complication with spine surgery is also common. This is understandable as the spinal cord and nerves are delicate structures and are an integral part of spine surgery. Many patients express a fear of paralysis or nerve damage from surgery, even though these risks are less than 1%.

The press also plays a role in generating fear. More often than not, the lay press will gravitate towards stories that deal with controversy, highlighting issues of complications or potential abuse. This is not unique to spine surgery, but plays a role in painting a negative picture of our discipline and our results. Shocking, provocative headlines sell magazines and
fuel the public (mis)perception that surgery harmsmost and helps few. For example:
• Why You Should Never Get Fusion Surgery For
Plain Back Pain; Forbes 2011
• A Knife in the Back; Is surgery the best approach
to chronic back pain?; The New Yorker 2002

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