We try to minimize invasive treatments as much as possible. For example, we would rather use topical gel than an oral tablet. We would rather do an injection even three times a year rather than an invasive surgical procedure. Even though spinal surgery is not recommended unless the patient really needs it, for some patients it is necessary. The explanation of when spinal surgery is necessary is not a simple issue. The following is a fairly simple/concise decription of a patient who needs spine surgery. One example of a patient in which spinal surgery is necessary is the case of a pinched nerve or radiculopathy. Radiculopathy in the low back, or lumbar spine, causes severe shooting pain down the leg and often to the foot (sciatica). The pinched nerve causes the sciatica shooting pain and if left untreated it will often progress to muscle weakness and possibly muscle atrophy. If the nerve is decompressed or unpinched the severe shooting sciatica leg pain will be dramatically improved although back pain may remain unchanged. The decompression of the pinched nerve will usually avoid any progressive muscle weakness and muscle atrophy. MRI and EMG can help identify the pinched nerve or radiculopathy. 

Selecting a competent surgeon may be the most important medical decision you ever make.  Every person is different in their physical / psychological makeup which will have a bearing on their recovery from the surgical procedure.  Even so, I have been impressed that some surgeons seem to have very good outcomes on the vast majority of their patients.  Dr. Thomas Coon was a Orthopedic Knee Surgeon at St. Helena Hospital.  I believe every patient I referred to him for Total Knee Replacement did well.  I have seen many of my patients with knee surgery by various surgeons not do as well.  UCSF (University of California San Francisco) has some very good Neurosurgical and Orthopedic Spine Surgeons – that is where I would likely go if I needed spine surgery (Eldon Eichbaum in Fremont also very good Spine Surgeon). John Dearborn in Fremont is a good Knee Surgeon.  Kirk Jensen and Theodore Schwartz are good shoulder specialists.  I like Golden State Orthopedics WALNUT CREEK CAMPUS (was John Muir Orthopedics) and Monterey Spine & Joint.  

Of course the location of my offices has some bearing on the doctors that we refer to just based on logistics (i.e. the time it takes for the patient to get to their office).  We are blessed to have many good surgeons (and good doctors) in the Bay Area.  Stanford University Medical Center offers very good care as well.  Dr. Loretta Chou (Stanford) and Dr. Jeffrey Mann (Oakland) are two of the best foot surgeons that I am aware of in the Bay Area (also Dr. Murali Moorthy in Walnut Creek).  

Please take some time when selecting a surgeon – you can’t “go back” once the surgery is done.  Be comfortable getting a second opinion.  And PRAY !!!

God bless you.