This is a scientific article, not a cure. Go to a regular hospital for medical treatment
Twenty years ago, a doctor said to a patient, “You need surgery,” and the surgery was decided. In other words, in those days the decision to have surgery or not was entirely in the hands of the doctor.
Generally, in the United States, after the doctor decides on a treatment plan, the patient is often advised to seek another consultation (sencond opinion) with another specialist in order to avoid errors. Generally this visit costs $450 to $550, and the price of medical care in the United States is high, more than 10 times that in China.
And now, with the development of society, diseases are becoming more complex and patients more knowledgeable. Patients are playing an increasingly important role in deciding their own destiny. In actual life, there are three situations.
The first situation is urgent or life-saving surgery, when the physician still plays a leading role, but the patient and family have a choice. Examples include malignant tumors, spinal fractures and dislocations, and severe nerve damage (foot drop, cauda equina damage – difficulty with urination and defecation, or muscle atrophy).
Typical cases, click to learn more about them
1.Giant giant cell tumor of bone – involving 3 vertebrae Whole block resection
2.Cervical spine trauma Posterior cervical spine single-opening enlargement of the spinal canal
The second type is functional surgery (e.g. general neurogenic cervical spondylosis, lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis). The patient’s problem is somatic distress, which does not affect life, but affects work and life. This is what is now often called “quality of life decline”. In this case, from the medical point of view, “serious impact on work and life, conservative treatment is ineffective, then surgery”. From the patient’s point of view, the most important conservative treatment method is bed rest, which can be supplemented by traction, physiotherapy and medication when the indications are clear. If it is really uncomfortable, then you can choose surgery.
(Jiang Liang original, please cite the source. Thank you.)
1. In clinical work, we often see that the condition on the film is serious and should be operated; but the patient himself is just a bad film, he does not have any discomfort. In this case, the nature of surgery is “preventive” – to avoid aggravation of symptoms and avoid paralysis. The problem faced by both the patient and the physician is that surgery carries risks, and conservative treatment carries the risk of exacerbation or even paralysis – it is difficult to tell which is more important and which is less important. At this point, the physician’s role is to inform the patient and family of the pros and cons of surgery and let them decide their “fate”.
2. Clinically, it is also common to see that the severity of the disease is similar on the films of different patients, but the symptoms are very different. For example, the same degree of lumbar disc herniation, some patients have been very painful, and some patients only slightly discomfort. At this point, it is also the patient who decides whether to operate or to be conservative, based on his or her own feelings and judging the degree of discomfort (which can only be stated clearly by him or herself and cannot be replaced by others). It is not the film that decides whether to operate or not.
3. Clinically, we can also see that the patients’ degree of “discomfort” is similar, but the patients’ attitudes are very different. For example, the same lumbar spine slippage, the same can only walk 200 meters, some patients feel that they can still take care of themselves, this is “enough”, choose conservative treatment; some patients can not accept this, because he (she) also want to travel, go to the park. In other words, different people have different attitudes to life and different quality of life requirements, so how to treat them is different from person to person. The risk of surgery at this time is surgical complications; and conservative treatment has no real effective way, so it can only delay the progress of the disease and face the problem of another 3 to 5 years, by which time the risk of surgery is even greater – because the body is aging + accompanied by hypertension and diabetes, etc. (due to low exercise leading to a decline in heart and lung function). At this point, the risks and benefits of various treatments need to be weighed by the patient himself, with the help and counsel of his family and the information provided by his physician.
Typical cases, click to learn more about them
1.Spinal cord type cervical spondylosis Male 70 years old Posterior cervical path Numbness and weakness of lower limbs…
2.Lumbar scoliosis + disc herniation 30-year-old female with back and leg pain for 4…
The third is cosmetic surgery (non-serious deformity, benign stationary tumor). It is entirely a patient decision.
Here is the second most common case, which is called “elective surgery” in medical practice.
(Original by Jiang Liang, please cite the source. Thank you.)
What you need to do before surgery.
The decision to have surgery or not is entirely in your hands, and all you have to do is make the final choice. Therefore, it is very important for you to consider as thoroughly as possible the pros and cons between doing and not doing the surgery, the risks and benefits you will face, and the probability of success.
You should learn and understand everything about your current medical condition (diagnosis) and the recommended procedure (procedure) before surgery. Ask your physician as many questions as possible about the situation to make sure you know in your own mind why the procedure needs to be done, how it will be done, the post-operative recovery process, and the expected results. You can ask your doctor to see if he or she can give you any written information or tell you to look at some information related to the surgery, such as books, pamphlets, web sites, or videos, etc., to help you understand your condition and the upcoming surgery more clearly.
1. Take the spinal cord type of cervical spondylosis as an example. The chance of sudden paralysis due to trauma is about 1 in 1,000, and the chance of paralysis due to surgery is also about 1 in 1,000. Therefore, the significance of preventing paralysis by surgery is limited. If the patient has no significant discomfort and fears surgery, and wishes to observe for 6 to 12 months, it is possible. Prof. Dang Keng-cho (my teacher) of Beihang Hospital observed 50 patients who had severe spinal cord compression but were asymptomatic, and some patients were observed for 10 years and were still fine. In other words, some patients may be symptom-free for life and may not need surgery for life as long as they avoid trauma. However, if the patient has relatives or friends who are paralyzed as a result, resulting in a great psychological burden; or if the home town is icy and snowy, where they often slip and fall and are prone to trauma; and the patient is worried about paralysis and thus requests surgery, it is possible. If there is numbness, weakness and inflexibility of the limbs, then it is recommended to operate directly without waiting.
(Click the link to go to “Severe cervical spondylosis, in danger of paralysis, is it suitable for surgery…”)
2. Take lumbar disc herniation as an example, see “Conservative treatment of lumbar disc herniation” for details
Most spine surgeries today are considered safe, but you still need to carefully discuss with your doctor some of the risks associated with the surgery that may come with it. Any surgery is accompanied by a certain percentage of complications (such as wound infections, anesthesia accidents, etc.). Many spine surgeries also carry additional risks, such as numbness due to nerve root injury, paralysis due to spinal cord injury, or difficulty with urination and defecation. Before you agree to any surgery, it is important to understand all the possible complications associated with the procedure. You need to “weigh the risks versus the benefits”.
While you may be deterred by the risks of surgery, you must also consider the risks you may face if you do not have surgery, such as persistent pain, further nerve damage, or even permanent disability. It is important for you to understand what is affecting your quality of life and how it will affect your life if you do not have surgery.
If you decide to have surgery, you will need to prepare.
You should adjust your physical and mental state before surgery. Comorbidities such as diabetes and hypertension should be controlled, and medications such as reserpine and aspirin should be stopped for a period of time.
Please click on the link to learn more about the science.
1.Severe cervical spondylosis, facing the risk of paralysis, whether it is suitable for surgery
2.Conservative treatment of lumbar disc herniation
3.Does lumbar spondylolisthesis need treatment?
4.Collar and back muscle exercise method (cervical spondylosis or post-operative cervical spine)
5.Surgery consultation for 76-year-old man, surgery risk? Too old?
6.Do I need to quit smoking and alcohol for spine surgery?
7.Progress in the diagnosis and treatment of spinal tumors
8.Progress in the diagnosis and treatment of spinal metastases
9.Minimally invasive treatment Spinal tumors Radiofrequency treatment of osteoid osteoma
Patients who are considering surgery, you can apply for my telephone consultation to communicate with me, click for details or call the appointment number 4008-900-120 (Monday to Saturday 09:00-19:00), and the staff will tell you the specific operation.
Click here to make an appointment for a quick visit and an exclusive interview time
Click here to view my clinic hours
Please click on the following links to learn more about the science.
I. Spine surgery.
1.Conservative treatment of lumbar disc herniation
2.Does lumbar spondylolisthesis need to be treated?
3.Can I get rid of it once and for all after surgery? –Cervical spondylosis, lumbar disc herniation, …
4.Severe cervical spondylosis, facing the risk of paralysis, is surgery suitable…
Second, surgical considerations.
5.The spine group of the Third North Medical Center: hospitalization procedures surgical costs hospitalization time
6.Out-of-town patients – reimbursement of surgical hospitalization fees
7.The orthopedic department of Peking University Third Hospital Introduction to the spine specialty
III. Spinal tumors and lesions
8.Progress in the diagnosis and treatment of spinal lesions and spinal tumors
9.Multidisciplinary diagnosis and treatment of spinal tumors (team introduction)
IV. Guide to Outpatient Clinic
10.North Medical College layout 2012 new outpatient building
11.North Medical Center Traffic Guide
[12] The real American working life — health insurance, education, pension… .
[13] High cost of medical care in the United States, 20% malpractice rate