We understand that spinal surgery can be a bit complicated so that’s why we aim to make things absolutely clear before you go ahead with any procedure.

Please read below for a selection of our most frequently asked questions:

1. What are the chances of dying or being paralysed after surgery?

This is a common fear among patients. With the advances in techniques this is now extremely rare.

In Low back surgery the risk is close to zero, as the spinal cord ends much higher up. In the neck the risk is 1 in 1000 operations. I have never personally had a patient paralysed after surgery in 15 years of practice.
 Nobody has died during surgery in 15 years I have been a consultant. Anaesthesia has become extremely safe and I work with very experienced anesthetists.

2. Who will do my operation?

If you are a private patient it will always be me (if you are my patient), and in the NHS it could be me, or a member of my team, who are training under me.

3. How long is the hospital stay usually?

These days all patients are admitted on the day of the surgery.

If you are having neck surgery you usually go home the next day, and for low back surgery the hospital stay is 2-3 nights on average.
When you leave hospital you will be walking on your own, have normal control of bladder and bowel function and your pain will be controlled with tablets.

4. What about post-op physiotherapy?

We will organise this for you close to your home if possible. Typically this starts 2 weeks after surgery and lasts 6 weeks on average.

5. How soon can one drive after surgery?

Typically around 10 days after surgery, as long as you feel safe to do so. Taking some short test drives to start with is a good idea.

6. How much walking should I do after surgery?

Begin slowly, but gradually build it up to walk a bit further every day.

There are no strict rules here. Some discomfort is okay. You could also take more than one walk a day.
Every person is different but it’s safe to walk a mile at 2 weeks and 2 miles at 4 weeks.

7. How much pain will I be in after surgery?

We take a lot of effort to minimise post-operative pain.

The first night is usually difficult but at the end of the first 24 hours there will be a significant improvement in the pain. There are a number of strategies we adopt include Patient Controlled Analgesia (PCA) – where you press a button and a pump delivers morphine through a cannula into a vein directly. We also use Epidural Catheters which delivers local anaesthetic directly into the wound and around the nerves.

8.How should I prepare for surgery?

Getting fit before surgery helps your post-operative recovery but this may not be possible if you are in a lot of pain. Stop any anti-inflammatory drugs a week before surgery as they can cause increased bleeding. You will also need to stop any blood thinning drugs like warfarin or clopidogrel – but only do this in consultation with your doctor.

9. I am very worried about the surgery. Is this normal?

Having an operation can be quite stressful and this is normal.

We can get anxious even if we tell ourselves everything is going to be fine. Many patients find that meeting other patients and speaking to them helps enormously. Do come to our coffee mornings and support group meetings, call the patients whose phone numbers you have been given or browse our online discussion forum via the website. You need to register first. If you have a question, no matter how trivial, please contact me via our ‘Ask a Question’ section.

10. When will the sutures/clips come out?

We usually use metal skin clips to close the wound and these come out at 10-12 days.

11. What are the chances of getting an infection?

With all the advances in surgery, and operating theatre techniques, we get about 1 major infection a year, so the infection rate for a major infection is less than 1% in our practice. This is treated quickly and we have no patients with a long term infection problem.

12. When can I go back to work?

This varies a lot and depends on many factors, but patients typically go back to work at 3-6 weeks after a low back fusion, and at 2-4 weeks after a neck disc replacement. It’s the patient who decides when they feel capable of returning to work, as this depends on their job as well. From a surgeons point of view though, there are no restrictions and patients can go back earlier if they feel fit. Several patients start by working from home, and then have a phased return to work.

13. How will it take to recover from the operation?

Again this varies. I would say that typically most patients get 80% of the benefits of the operation within 3 months, but continue to improve for up to a year after surgery.

14. What about exercise after surgery?

This is a very important part of your recovery.

As your pain settles you will start physiotherapy and they will guide you about the exercises you need to do. The MOST IMPORTANT thing is to keep doing them even if you get better – as it really helps protect your back for the long term. A combination of Pilates and Aerobic Exercises done about 3 times per week for 30 minutes, is a good maintenance regime .

15. Will I need a catheter to pass urine?

Some patients need a catheter in their bladder to help them pass urine after surgery. This is usually put in by the nurses on the ward and comes out the day after surgery.

16. Can I go back to sport?

A lot of patients go back to regular sport after surgery, including running marathons, playing football, rugby, golf, tennis, hill walking and we even have a triathlon runner. Your physiotherapist will guide you afterwards. See the website for several inspirational stories.

17. What about my medication after surgery? When can I stop it?

This varies, but we encourage patients to gradually come off their pain killers as their pain settles.

If you have been on opiates (morphine, tramadol, codeine etc) for a long time- you will find this more difficult and may experience withdrawal symptoms. In this case you need to come off the medication more slowly. If you are on Gabapentin or Pregabalin for nerve pain, you need to come off these tablets slowly. Ask us for advice if you are unsure.

18. How do I know if I am bad enough to have surgery?

Pain is very subjective. It all depends on how limited you feel by your pain and disability.

If you have had pain for some time, and find it difficult to do the things you normally enjoy doing, then surgery is worth considering. Patients typically have surgery either for intrusive pain, because they are sleeping poorly because of it, or if they cannot do the things they enjoy doing. Surgery has become very safe in the last decade and the outcomes have improved, so it’s not worth suffering in silence for the long term. Surgery of course should only be considered if non-surgical treatments have been tried and found not be effective.

Every person is different. Some are in severe pain and others have less pain, but cannot do the things they are passionate about… and each is good reason to consider surgery.