[Quixote]

... but I felt that this subject is important enough to offer my experiences that stem from the "philosophy" of my particular neurosurgeon who has operated on my back three times (and has suggested that there is the potential for more surgeries, given the condition of my spine...). He is not local and is one of the few doctors that I would unhesitatingly travel to for treatment.

His premise is that he "does not operate based on pain but rather based on deficit." He feels that "pain" that cannot be linked to a specific, measurable physical issue that is correctible with surgery should result in surgery. That he leaves to pain management. In other words, he is not knife-happy and recognizes that there are no promises when it comes to back surgery—and that any neurosurgeon that says that there are "guarantees" is one that needs to be seriously questioned.

The first time he operated on me, I had developed foot drop that was so subtle that I was barely aware of it; it was the pain that resulted from a disc that had spontaneously exploded, a fragment of which had lodged in my spinal cord at the point that the sciatic nerve exits. Immediately after surgery, he came in to see me in the recovery room and demonstrated to me that he could no longer pull my foot down, as he had been able to do only hours before.

The second time, I had had no pain, but I could not lift even a telephone receiver with my left hand. Immediately after surgery, he let me briefly lift a heavy item, just to show him—AND myself—that I could. This surgery involved a cervical fusion, the substitution of cadaver bone for the disc that was completely deteriorated, and the insertion of a plate held in place by four screws.

The third time my mobility had become limited, and he operated to clean out facet (sp?) joints, which resulted in the comparative ease with which I was now able to move and twist.

In all three cases I was discharged from hospital the day following surgery; I was given prescriptions for pain meds which I never had to use. And today, the successes of the first two operations show that the positive results have been and are permanent; for the third, the facet joints continue to deteriorate, though I doubt I'll go through the surgery again but rather will just live with it. Though WE tend to focus on the neurological pain, here's a surgeon whose approach—NOT based on pain—has consistently worked well. Perhaps THIS approach is worth any patient's discussing with her or his neurosurgeon prior to considering surgery....