Finding a Surgeon Who Will Minimize Risk

How do you pick your back surgeon?

It’s an important question for anyone needing to undergo spine surgery, and for Andrew Brunson – it’s something he’s had to do twice. Once in 2016 – when he had a spinal fusion on his neck at a major medical institution and then more recently in 2021 – when came to see me for a disc replacement. 

“The first time I had a two-level spinal fusion and the doctor was highly trained and very experienced. The surgery worked but it was a very difficult recovery,” Andrew explains. “The fusion limits my mobility. I had trouble swallowing since it was in my neck area. I was weak for months and my voice lost much of its strength. It took me about eight months to get back to normal with my voice.”

Andrew is a pastor and speaker so his voice is his livelihood. After finally getting his voice back and feeling good for a few years, he was obviously very worried when he started having numbness in his extremities in late 2021. The first surgeon he consulted suggested another spinal fusion. Andrew didn’t like the idea of even less mobility in his neck – or the way the doctor described the procedure. 

“He was really cavalier,” Andrew recalls. “He said – ‘You may have to have your whole neck done. We’ll unzip you and this could kill you.’  I was also told I could lose my voice or there could be damage to vocal cords. I knew there could be trouble swallowing and paralysis is an extreme risk and I was afraid of all of that.

Getting a Second Opinion

So Andrew did some research, sought out a second opinion and that led him to me. From the start, we talked about how to minimize risk. I always want to be as careful as possible to reduce pain, fix their problem, speed up their recovery and get them back to living the life they want. Minimizing risk is also part of an individualized conversation I have with every patient. I do have a checklist full of lots of options and depending on the procedure, the patient, their life and activity, their goals and their needs – we figure out what we need to do before, during and after surgery to produce the best possible outcomes.  

Since Andrew was concerned about paralysis and losing his voice, I decided to run an arterial line during his procedure to monitor his blood pressure since a drop in blood pressure increases the chance of paralysis. I referred him to an ENT before the procedure so we could get a baseline view of his vocal cords. We had him get a bone density scan too to give us additional important information. Knowing he had a big international speaking engagement coming up in a month, we moved his surgery up so he’d be ready for that event. And because he had difficulty swallowing after his first procedure, I gave him steroids for a few days after surgery to reduce inflammation.  

Minimizing Risks

“Dr. Jazini took so many extra, precautionary steps and safeguards to minimize risk – especially compared to my first surgery,” Andrew says. “His care and attention to detail was really reassuring. I didn’t have any of those things the first time.”

I performed a disc replacement on Andrew in February 2022 and everything went well. “This second time around it was such a different level of care and I had a much better recovery,” Andrew explains. “It was easier, there was less pain and with the steroid pack I didn’t have trouble swallowing like I did the first time. They also gave me tips – about turning my head to ease swallowing and they let me know when swelling would peak. I got so much more information and that was really reassuring too. I also didn’t have the same weakness for as long and my voice came back pretty quickly. So it was a much better recovery.”

Most importantly – Andrew made his international speaking engagement one month later. The lesson for other patients in his story is – talk with your doctor – not only about the actual procedure – but about all the many ways they can reassure you and minimize risk so you can get back to your life as quickly as possible. 

“I really appreciated Dr. Jazini’s honesty that there aren’t ever any guarantees. But he did the next best thing,” Andrew says. “He was clear about the risks and then did everything he could to minimize them and that made this second procedure a far better experience.”