Preparation
SELECTIVE NERVE ROOT BLOCK
Texas Back Institute wants to make sure you are well informed about any surgery you may be considering. Please review the checklist below to help you through this stressful time:
What to Expect
- Learn as much as you can about the physical conditions causing your spine pain and limiting your activities.
- Make sure that you have explored other options and that you feel confident that surgery is the best option for your condition.
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Make sure you ask the following questions:
- What type of surgery are you recommending and why?
- What is the source of the pain that is being addressed? How do you know this? You should note that exploratory surgery is never done on the back.
- 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!
- What are my non-surgical options?
- What is the natural course of my condition if it is not surgically addressed?
- What would you recommend if I was your friend or loved one?
- How long will the surgery take?
- What are the side effects, potential risks, and potential complications?
- Please explain the risks and how they relate to me personally. Different risk factors like smoking, being overweight, or having grade 3 spondylolisthesis, etc, will affect surgical outcomes.
- What if, during my surgery, you encounter a different spine issue than you expected?
- 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.
- 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?
- Who else will assist you in the operation and what are their background and qualifications?
- 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?
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Understand the physician’ background and experience by asking the following questions:
- How many times have you done this procedure? Generally, when it comes to surgery, “practice makes perfect,” so more experience is better.
- Are you board-eligible or board-certified? You can usually look on the wall and see a certificate.
- 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.
- If I want to get a second opinion, who would you recommend? The recommendation should be someone not in the same practice.
- Statistically, what is the success rate for this type of surgery? What is your personal success rate, and how many of these types of surgery have you done?
- 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. Note 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.
- Discuss your understanding of your physical condition and your surgery with the surgeon, so that you are working together. Come prepared to ask the surgeon any questions you may have.
- Learn about actions you can take to prepare for the surgery such as proper nutrition and exercise.
- Get sufficient sleep.
- Examine your emotions and discuss any negative feelings such as depression, anxiety, stress, or anger with a qualified mental health professional. Negative emotions can lead to poor surgery results
- Limit narcotic intake prior to surgery as much as possible. Long-term use of high levels of narcotics makes post-operative pain control more difficult to achieve and is associated with poor surgery results. Discuss any problems you have had with narcotic medications with your physician.
- Keep as active as you can prior to surgery. Keep working if possible. Inactivity causes muscle weakness, decreased endurance, and you lose important aspects of your life.
- Learn realistic expectations for the results of spine surgery, including how much pain relief to expect, how much you can expect to improve your abilities to engage in activities, whether you can return to work, etc. Do not set yourself up for disappointment by expecting more of the surgery than it can deliver.
- Recognize that surgery only creates the foundation for your recovery and healing. Where the surgery takes you depends on your own efforts to be as healthy as possible.
- Determine what arrangements will be needed for your post-operative care, if necessary. Involve family members in appointments with your physician and in care planning so that they can best understand and promote your healing process.
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Understand what you can expect post-surgery by asking the following questions:
- What kind of pain should I expect after the surgery and for how long?
- How long is the hospital stay?
- May a family member spend the night with me in the hospital?
- How do you manage the pain in the hospital?
- Which pain medications will I be sent home with and what are the possible side effects of these prescriptions (e.g. constipation, drowsiness, etc.)?
- Will you know before the surgery if I will need a back brace afterward? If so, will I be fitted for one before the surgery?
- Will I need any other medical equipment (like a walker) when I go home?
- Who can I call if I have questions after the surgery? What is the process for communication?
- How often will I see you after my surgery?
- What symptoms would warrant a call to your office?
- What symptoms would warrant immediate medical attention?
- What limitations will I have after surgery and for how long?
- How long should I wait to bathe?
- How long will I be out of work? School?
- What kind of help will I need when I return home?
- When can I drive again?
- When can I resume normal (light) household chores?
- What expectations do you have for my recovery?
- When is it safe to resume sexual relations?
- How soon after the surgery can I start physical therapy?
- Seek balance between activity and rest. Push yourself to gain strength and endurance but be aware of pain, and let it act as your guide. Do not undertake activities (especially during the initial post-op period) that you know will cause a major increase in pain. Do not undertake activities that you know you can only do if you take pain medication.
- Recognize that healing is unlikely to be rapid or easy, and will involve setbacks. Commit yourself to staying positive and pushing for improvement even when it is difficult. Do not blame yourself when your recovery is not going as you expect.
- Make healing your work. Do not feel guilty that you can not do your normal job, or do household tasks, as you recover from the surgery. Accept that you have limitations while you heal.
- Examine what’s important to you and commit yourself to it, while adapting to any limitations you experience.
- If you were taking antidepressant medication before surgery continues taking it for at least 4-6 months post-op even if you are feeling great. Stopping an antidepressant during the post-operative period can cause you to become depressed and negatively affect your recovery.
- Accept help and support from others. Don’t let pride or habit lead you to undertake activities when others would gladly assist you. Don’t forget to give them support, also.
- View surgery not as an end of pain, but as a beginning—a resetting of the foundation for you to regain health and vitality.
- Set goals for your recovery, but stay flexible. Some goals may need to be delayed, others may need to be abandoned. View changing your goals as a victory for your ability to adapt.