So you think you need . . . Lumbar surgery:If you must have lumbar surgery

* Have surgery in a multidisciplinary setting combining medical and mental-health care, physical therapy and other treatments. Patients do better with such an approach and are also more likely to return to work (Pain, 1992; 49: 221-30).


* Only have the operation if you are under 60. A more advanced age is associated with a higher risk of complications (J Bone Joint Surg, 1996; 78: 839-47).


* Stop smoking, as this reduces blood supply and so impairs healing.


* Check out your surgeon – make sure he is experienced in the operation and has a successful track record.


* Consider taking homoeopathic Arnica before and after the operation to aid healing and minimise bruising.


* Tell your surgeon and anaesthetist about any medications – traditional or herbal – that you are taking.


* If your operation involves a prosthetic disc, it may include titanium to encourage bone ingrowth. But, as a result of normal wear, titanium debris eventually accumulates, stimulating a macrophage and cytokine immune response which may have adverse effects on spinal tissues (Spine, 1999; 24: 899-903).


* Lose weight before you go under the knife as obesity can increase the usual risks of surgery (Rev Chir Orthop Repar Appar Mot, 2004; 90: 5-15).

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What Doctors Don't Tell You Written by What Doctors Don't Tell You

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