View Full Version : Questions for doctor

12-05-2003, 09:20 PM
I was wondering if anyone has a list of important questions to ask the drs when considering surgery.



Patty Gregory
02-11-2004, 06:20 PM
I saved this very helpful list from the Scoliosis Mailing List. I think it offers some wonderful suggestions. Hope it helps you.

Questions To Ask Before Surgery (by Jim Fisher, appeared on Scoliosis Mailing List on 8/8/99)

1. Having examined our daughter's X-rays and her history, is surgery indicated? Is it absolutely necessary? What is the danger of not having the condition corrected? How long, in your estimation, before her condition becomes debilitating? How long before it might be life-threatening?
2. How long have you been performing scoliosis surgery? How many do you perform in a year? Do you perform any other kinds of back surgery on a regular basis? What other doctors and health care professionals would be on your surgical team?
3. What long-term follow-up procedures do you use with your patients? What is the most common complaint several years post-op?
4. In our daughter's case, would you be recommending donating blood for autologous transfusions? How many units? Will you be recommending her taking Procrit? What form of iron supplements do you recommend during the donation period? Would she be able to give as many units as might be needed? How early before surgery can donation begin?
5. Would you recommend that our daughter have an MRI scan of her back prior to surgery? If so, how early before the surgery would this be most useful?
6. Is a thoracoplasty indicated?
7. Which vertebrae would you suggest fusing? What is the best lateral plane correction we can hope for? What degree of sagittal plane correction is possible? How long might the surgery take?
8. Describe the fusion hardware for us. What metal is the hardware made out of? How is it anchored? Is there any chance of rejection? Might it set off metal detectors in the airport?
9. Will you be using autologous bone for the grafts, or using DBM (Demineralized Bone Matrix), or some other kind of donor bone? If autologous, will you be taking it from the iliac crest or using rib bone?
10. Is anterior removal of disks indicated? If so, which ones and would you be using an endoscopic procedure to remove thoracic disks?
11. What procedures do you follow to reduce the possibility of neurologic damage? Do you use the waking test? How many cases of neurologic compromise have occurred in this area as the result of a scoliosis surgery in the last decade. What was compromised in these cases?
12. How much taller might our daughter be after surgery?
13. Describe the hospital stay. How long would she typically stay in the hospital? How long before light activity? How long before she will not need a parent staying with her throughout the day? How long before school can be resumed? How long before sports can be resumed? What long-term activity restrictions are recommended? What pain control measures would need to be taken during the hospital stay? How long before pain control is typically no longer needed? How long might the scar remain tender enough that she might need a pillow to feel comfortable in a sitting position?
14. What measures should we take to prevent post-operative infections?
15. How would the fusion affect our daughter's ability to participate in competitive swimming (racing dives, flip turns, butterfly stroke), drum line (carrying a bass drum), track (pole-vault and hurdles), ballet, scuba diving, cycling, horseback riding, skiing, canoeing, and sky-diving?
16. What do you know about the possible long term problems with this type of surgery (not counting the problems with Harrington Rod surgeries)? What are the probabilities of pseudoarthrosis, stenosis, fusion disease (degenerative disk disease), and pain between the shoulder blades many years later? What can be done to reduce these probabilities? My concern is with the additional mechanical stress taken on by the non-fused lumbar vertebrae. The stresses normally absorbed by many joints are concentrated onto the few that remain flexible. What long term effect does this have on our daughter's body? Might she experience degenerative conditions later on in her life?
17. After fusion is complete, what stresses do torso twisting, bending backward, jumping, bending forward, and lateral bending put on the fusion and the remaining joints? Which of these motions are more stressful than others? What exercises are recommended? Which ones should be avoided? For example, would exercises that isolate and strengthen the rhomboid muscles be a good thing? What about the deltoids or the paraspinals?
18. What research is currently underway investigating the etiology of scoliosis? What organizations would you suggest we support financially to promote this research?