Decisions to make before a back operation

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The decision to have back surgery is a big one. Both you and the doctor need to be convinced that there is no other way of solving the problem.

In order to arrive at this decision, your doctor will perform a thorough medical evaluation, which will include a study of your medical history, a physical examination and some imaging tests.

These tests may include normal X-rays, myelography, a CT or CAT scan (computerised tomography) or an MRI (magnetic resonance imaging) scan. The MRI scan gives the most detailed image of the soft tissue, followed by the CAT scan. The MRI scan can give up to 100 times more accurate information on a patient's condition than normal X-rays, but sometimes a normal X-ray can tell a doctor all he/she needs to know.

For your own peace of mind, it is always a good idea to get a second opinion. If two spine specialists agree that surgery is the only option, you can be more confident that you are doing the right thing.

While back surgery can help relieve the pressure on spinal nerves, many people have overoptimistic expectations concerning the results of back operations. It is probable that you might continue to have pain for quite a while. Full recovery is also not quick – it could take weeks or months. Most people undergo intensive physiotherapy after a back operation.

There is a lot you can do to improve your back health after surgery. These include improving your posture, strengthening your muscles by means of regular exercise, stretching and controlling your weight.

Reviewed by Dr Pradeep Makan, orthopaedic surgeon, Melomed Gatesville and Life Vincent Pallotti Hospital in Cape Town and part-time lecturer in the department of orthopaedic surgery at the University of Cape Town, 2010.

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