Considering Spine Surgery? What to Know for Those Seeking Relief from Pain

Intro: This is Weekly Dose of Wellness brought to you by MemorialCare Health System. Here's Deborah Howell.

Deborah Howell (Host): Welcome to the show. I am Deborah Howell, and today we'll be talking about spine care and what you need to know to seek relief from pain. Our guest is Dr. Amandeep Bhalla, an orthopedic surgeon at the Spine Center at Long Beach Memorial Hospital. Welcome, Dr. Bhalla.

Amandeep Bhalla, MD: Good morning. Thank you, Deborah.

Deborah Howell (Host): You know, having a spine issue is more than just having a bad back or neck. Fewer than 5% of people with back pain are good candidates for surgery. Yet for patients with serious structural problems or disease, back surgeries are often highly successful. What are some of the symptoms that might indicate someone is a candidate for spine surgery?

Amandeep Bhalla, MD: Sure, that's a great question. Usually, if somebody has neurologic complaints, that tends to make them a great candidate for at least evaluation and discussion about treatment options, which might include surgery. Neurologic complaints usually are pain in the arms or hands, numbness, and tingling, and the same for the legs and buttock region where you can have pain, numbness, and tingling. And those are some of the symptoms patients with spinal disease and nerve impingement might present with.

Deborah Howell (Host): Okay. And when should someone who is living with low back and leg pain consider surgery?

Amandeep Bhalla, MD: Sure. I think the consideration for surgery starts with initial evaluation by someone who is specialized in spine and has a good medical understanding of conditions and treatment options. And usually, conservative therapies are often tried first, such as anti-inflammatory medications and physical therapy. And then sometimes there's advanced imaging like MRI that is involved to study the anatomy, and taking that information into account and with a discussion with the patient about their expectations, consideration for surgery can be had.

Deborah Howell (Host): Okay, well now let's say we have the thumbs up for surgery. So what can the Spine Center do for someone needing spine surgery?

Amandeep Bhalla, MD: Sure. One of the advantages of the Spine Center that's distinct is it's a comprehensive program, and it specializes in treating spine patients day in and day out. And it helps to educate patients about the post-operative recovery course as well as any of the in-hospital experience if the patient is going to be staying in the hospital, as well as for outpatient surgery as far as managing expectations, understanding, and the post-operative recovery plan.

Deborah Howell (Host): Alrighty. How is technology changing spine surgery at the Spine Center at Long Beach Memorial?

Amandeep Bhalla, MD: So technology, we do have a very well-trained staff that's facile with the latest technology and techniques there. And the Spine Center supports that new and latest training by implementing very modern technological equipment such as the O-arm would be an example, which is a computer-navigated system which increases the precision during surgery by showing the three-dimensional anatomy for instrumentation in patients who are undergoing spinal surgery with instrumentation. This piece of technology can improve the accuracy, and it is a state-of-the-art piece of equipment that the Spine Center acquired in 2017.

Deborah Howell (Host): Robots really are our friends, aren't they?

Amandeep Bhalla, MD: I think so. I think if we partner up with them in the right way.

Deborah Howell (Host): Right, exactly. And don't let them take over. Now if someone is suffering from ongoing neck or back pain, what steps can they take to get help?

Amandeep Bhalla, MD: I think reaching out to the Spine Center in Long Beach is an option, and I think discussion with your primary care physician should you need a referral to see a spine specialist. I think if you have neck or back pain and are unsure where to start, seeing a specialist can certainly help create a roadmap for treatment, which most of the time doesn't even involve surgery. So I think contact with a specialist is helpful in framing how to approach some of these problems.

Deborah Howell (Host): Okay. Is there anything a patient can do to be well-prepared for their spine consultation?

Amandeep Bhalla, MD: Yeah, I think having prepared their prior medical records, if they have any outside MRIs or imaging, to have that available on a CD so that they can be reviewed at the visit. And just a list of questions that they might have, and those types of things will help make the visit more constructive.

Deborah Howell (Host): Sure. Well, it's certainly a better day to be a patient in this world. Is the percentage still really at 5% good candidates for surgery?

Amandeep Bhalla, MD: Yeah, you know, I think anecdotally, when you talk about back and neck pain, it's probably even less than that. Really the majority of back and neck pain can be treated non-operatively, and it's through careful selection, understanding which patients can benefit from surgery, that that number tends to be pretty low.

Deborah Howell (Host): Wow. Okay. Well, let's hope we can get that percentage up in the years to come.

Amandeep Bhalla, MD: Sure.

Deborah Howell (Host): How can people learn more about spine surgery options, doctor, at the Spine Center at Long Beach Memorial?

Amandeep Bhalla, MD: So I think the website memorialcare.org/lbspine is a great resource for information. They can also call 1-800-MEMORIAL for a referral, but I think the memorialcare.org/lbspine website is probably a great place to start.

Deborah Howell (Host): Well, thank you so much for directing us to that site, and we really enjoyed having you on the show today, Dr. Bhalla. Thank you for your time and your expertise.

Amandeep Bhalla, MD: Thank you. You have a nice day.

Deborah Howell (Host): We'll do. For more information or to listen to a podcast of this show, please visit memorialcare.org. That's memorialcare.org. That's all for this time. I'm Deborah Howell. Have yourself a terrific day.