Making a decision about surgery
Deciding if surgery is right for you is a big decision. Many areas of your life affect this decision. Here are some ideas as you consider surgery.
Questions to ask about having surgery
Download and print a list of questions to ask yourself to help you and your health care team decide if surgery is right for you, and if so, which type of surgery.
What are the risks of surgery?
No surgery is risk-free. All surgeries have a small risk of problems, such as:
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Infection or bleeding at the surgery site
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Problems caused by the medicine that puts you to sleep during surgery (anesthesia), such as feeling sick to your stomach or throwing up. Very rarely, patients die from a reaction to anesthesia.
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Stiffness and scarring
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Problems healing where the surgeon made a cut (incision)
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Pain, loss of feeling, or a tingling feeling at the incision
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People with SCI have some other risks from surgery, including:
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Chance of pressure sores, which can happen when someone spends long hours laying down or sitting
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Autonomic dysreflexia, which is sudden high blood pressure that can be dangerous
Am I healthy enough for surgery right now?
Some health problems can prevent you from having surgery right now.
Before you can move ahead with surgery, make a plan with your health care team to deal with any of these:
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Pressure sores or other open wounds
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Any infection, such as a urinary tract infection (UTI)
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High blood pressure or diabetes that is not under control
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Serious heart and lung problems
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Being very overweight (extreme obesity)
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Some problems that are linked to your SCI can prevent you from having surgery, such as:
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Continuing to lose strength and movement, even after 6-12 months. This may be a sign of a problem in your spinal cord called a syrinx (a fluid-filled cyst). Tell your health care team if this is happening to you.
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Permanent stiffness in your joints
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Muscle spasms that happen often (although sometimes surgery can treat the spasticity)
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Sudden or uncontrolled high blood pressure
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Also, think about your mental health. If you are feeling depressed, anxious, or uncertain, this can make it harder to heal from surgery and stick with your rehab plan. Talk to your doctor to get help.
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Your health care team can help you think about all these things. As time goes by, things may change, and you can reconsider surgery.
How soon do I have to make a decision about surgery?
Keep the window of opportunity open and talk to your health care team about surgery as soon as possible (ideally within 6 months after SCI).
Some nerve transfer surgeries are time sensitive and may only be an option within 6-12 months after SCI. ​Talk to your health care team early so you have time to think things over, get an evaluation, and make a decision.
What can surgery really do for me?
You should have a realistic idea of what surgery can and cannot do.
Surgery can improve some movements and help you do some activities more independently. For many people, this greatly improves their quality of life. It does not restore the level of movement you had before your SCI.
Having surgery is a serious decision that is affected by:
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Your personal thoughts, feelings, and goals
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The pattern of injury you have
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Your living situation, including:
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Your job and financial situation
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The amount of caregiver support other people can give you after surgery
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Ask yourself these questions about surgery for SCI
To start thinking about your surgery options, answer the questions below. Your answers to these questions (and other questions your surgeon may ask) will help you and your surgeon decide if surgery is right for you, and if so, which type of surgery.
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Questions to ask about having surgery:
You can download and print these questions and bring them to a visit with your health care team to guide your conversation about surgery.
1. How long has it been since your injury?
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Less than 6 months
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Between 6 months and 2 years
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More than 2 years
2. How much support do you have from other people in your life, such as family or close friends?
For example, people who would be able to help you as you recover from surgery.
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I have 1 or more people that I can rely on for help every day
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I have people who could help me, but not every day
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I am mostly on my own
3. How would you pay for surgery and rehabilitation (rehab), after surgery, such as physical therapy? (Some of these answers may only apply if you live in the US.)
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I have private health insurance that would pay for surgery and rehab (Most health insurance plans cover these surgeries. Out-of-pocket costs, such as co-pays and deductibles, vary by plan.)
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I have health coverage through the VA
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I have other coverage that would pay for surgery and rehab, such as Medicare or Medicaid
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I’m not sure how I would pay for surgery, rehab, or out-of-pocket costs
4. How long can you wait to heal from surgery before you need to get back to work, school, or other things you do?
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I can take as long as I need to heal
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I can take a couple of weeks or months to heal
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I have to get back to work, school, or other activities pretty soon after surgery
5. How are you with pain?
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I worry about pain and avoid it as much as possible
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I can deal with some pain for a while
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I can deal with pain with no problem
6. Do you have transportation to get to surgery and rehab?
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Yes: I can get to where I need to go easily
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Sometimes: It takes some effort to set up transportation, and I can’t get it all the time
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No: Transportation is a problem for me
​7. What are your goals for regaining movement? For example, is there a specific activity you want to be able to do on your own?
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I’m not sure
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I have an idea, but I want to learn more
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I have specific activities I want to do again (please list):_____________________________________
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I only want surgery if I can get the movement I had before my SCI
What if surgery is not an option for me?
If you have a health problem other than your SCI that prevents you from having surgery, such as pressure sores or frequent urinary tract infections, talk to your health care team about it. You may be able to:
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Talk about your goals for surgery
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Make a plan for dealing with your health problems