How to prepare for spine surgery? Dr. Anton Titov, MD. Leading Boston-based spine surgeon shares tips for preparing for surgical operation. not just for spine surgery. Why medical second opinion is important for anyone considering undergoing any type of surgery? Dr. Anton Titov, MD. How to get ready for surgical operation if surgery is indeed required? How preparing for surgery correctly can improve clinical outcome? Dr. Anton Titov, MD. How to prepare for spine surgery? Dr. Anton Titov, MD. How to prepare for spinal surgery - Video interview with leading expert in spine surgery. Preparation Before Back Surgery is important. Dr. Anton Titov, MD. You should get medical second opinion to confirm that surgery is indeed required. How to prepare for spine surgery is important for patients to know. Medical second opinion confirms that degenerative spine disease diagnosis is correct and complete. Medical second opinion also helps to choose the best treatment method for herniated disc or spinal stenosis. Seek medical second opinion on back pain and be confident that your treatment is correct. Surgeon should explain to every patient how to prepare for spine surgery. Patients should learn all about the surgical procedure they will have. Patients should ask about happens right before the procedure. Patients learn what happens in the operating room, what happens postoperatively. Well-informed patient has less anxiety before surgical operation. This improves clinical outcomes. Preparing for Lumbar Spinal Fusion includes cessation of smoking. Smoking is a very negative factor in surgical clinical outcomes. Smoking also has specific toxic effect on bone healing. Key things you need to know about preparing for surgery are education and improvement in your stamina and flexibility. The best is to start physical therapy before surgery. Preparing for low back surgery well makes recovery faster and less painful for the patient. Knowing how to prepare for spine surgery is a crucial factor in spine surgery success. How to prepare for spine surgery. Medical second opinion for spine surgery. Dr. Anton Titov, MD. Dr. Eric Woodard, MD. We spoke a lot about various conditions that require spinal surgery. Sometimes surgical operation is necessary. What is the best way to prepare for spinal surgery? Dr. Anton Titov, MD. Dr. Eric Woodard, MD. Spine surgeon, New England Baptist Hospital, Boston. First of all, learn as much as you can about the surgery. Dr. Eric Woodard, MD. I strongly recommend second opinions. there should be consensus in the indications and the intended procedure among at least two sometimes even three experienced senior spine surgeons. medical second opinion gives you a lot of confidence that you are making the right decision. that is first and foremost. Dr. Anton Titov, MD. importantly it allows a person to be treated because of the clinical conditions. Not because of radiographic finding as you mentioned earlier in our conversation. Dr. Eric Woodard, MD. No question about it. The radiographic results and findings on MRI of the spine have to match the clinical symptoms. But there also has to be a failure of non-surgical treatments. Those three elements go into the ultimate decision to pursue surgery. once you have agreed with your surgeon and your medical second opinion that surgery is probably the best option for you. Now preparation and education is paramount. For instance here we have a very robust pre spine surgery education program. The nursing staff runs this patient education program. Patients learn a lot about the anatomy, about the intended procedure. Patients see some of the instruments that there are going to be used in their spine. Patients talk about what's going to happen right before the procedure. Patients learn what happens in the operating room, what happens postoperatively. Patients learn what the expectations for the entire experience are going to be. that goes a long way to relieving a lot at the unknowns. It relieves a lot of the anxieties that are associated with any surgery, not just spinal surgery. Secondly, the other big factor we champion pre-operatively is to try and get the patient in the best shape of their life. Sometimes they possibly can get into better shape. Now there are limitations to this. Because the reason patients are having spinal surgery are typically pain or weakness. But if you think about what happens physiologically to the body just from surgery and all the after-care. This is similar to a sporting event or running a marathon. Dr. Anton Titov, MD. You to have to prepare. Dr. Eric Woodard, MD. I try to engage my patients into physical therapy pre-operatively. This helps to maximize their flexibility and their fitness. It helps to have them glide through surgery in the best possible way. Dr. Anton Titov, MD. What kind of lifestyle modifications do you recommend to your patients prior to surgery and after the surgery? Dr. Anton Titov, MD. Dr. Eric Woodard, MD. Prior to the surgery, as Dr. Eric Woodard, MD. I said, flexibility is probably most important. Dr. Eric Woodard, MD. I mean we all like a strong body core. It is essentially strong abdominal region. But flexibility can go a long way toward facilitating movement afterwards, when you have some surgical pain. Sometimes your joints are a little more flexible it facilitates your ability to move after surgical operation. It helps your ability to participate more effectively in the post-operative care. Dr. Anton Titov, MD. There is a big problem with patients smoking, especially men. especially men in the age group and demographics that might require spinal surgery. Smoking negatively affects many physiological processes and tissue repair. How does smoking affect the process of spinal surgery? Dr. Anton Titov, MD. Dr. Eric Woodard, MD. Absolutely. Smoking on a number of fronts is a real challenge. Smoking is a real negative factor in overall clinical outcomes. First, there are just negative the physiologic aspects of smoking. Smoking puts you at high risk for heart disease and having a cardiac event during anesthesia. Smoking makes anesthesia more difficult because of the direct effects on lungs. Smoking increases secretions and your risk for pneumonia postoperatively. But the nicotine has a very specific toxic effect on bone and on bone healing. People who are cigarette smokers typically have a higher degree of arthritis or degenerative disc disease to begin with. smoking causes degenerative spine disease to begin with. Number two, smokers clearly have a higher risk of bone mineral loss. Smoking leads to osteopenia and osteoporosis, especially in the cervical spine in females. Then the other big problem with nicotine is its negative effect on the ability to form new bone. when we are fusing the spine the effective failure of fusion, called a nonunion, is much significantly higher in folks who are using nicotine products than in those are not. Dr. Anton Titov, MD. patients shouldn't smoke in general but in particular they should quit before any kind of spine surgery. Dr. Eric Woodard, MD. Dr. Eric Woodard, MD. We ask patients to be nicotine free for at least three months prior to spinal surgery. Dr. Eric Woodard, MD. We also ask to stay away from smoking for least six months after surgical operation. Especially if we are performing a spinal fusion surgery. fusion of vertebral bodies. How to prepare for spine surgery? Dr. Anton Titov, MD. Video interview with leading expert in spine surgery. Why medical second opinion is important? Dr. Anton Titov, MD. How to recover faster after surgery? Dr. Anton Titov, MD.