Ask a Doctor

Q: What questions I should ask my surgeon?


he most important thing to gain from the visit with the spine surgeon is to know the diagnosis. Once we figure out what is going on, we develop a treatment plan for each patient. Best advice we can give: be honest. Tell us how the pain is affecting you. That will help us determine how best to treat you.

Ask Your Question!

To schedule a new patient appointment or to ask a question, please call Texas Back Institute at 972-608-5005 or email Our clinical concierge will match you and your specific need with the appropriate facility/physician.

I’ve heard a lot about artificial discs. Who can be treated with these?

Total disc replacements (TDR) or artificial disc replacements (ADR) are designed for the treatment of disabling pain from disc degeneration in either the neck or lower back. They provide pain relief while preserving motion. A patient is generally not considered for TDR surgery unless they have failed to gain relief from active therapy with or without medications or injections for a period of at least six months. Lumbar artificial discs are put in through the abdomen. Patients with previous abdominal surgeries in the area of the lower spine, patients with too large of an abdomen or patients with pain primarily coming from the joints in the back part of the spine may not be candidates. An evaluation by a trained surgeon is necessary to make that determination. A cervical TDR may be appropriate if a patient has not responded to a minimum of six weeks of treatment with medication, therapy or injections and is being considered for a fusion. Patients with fractured spines or osteoporosis are generally not candidates. Only after being evaluated by a surgeon can it be determined if TDR is a viable option for you.

Many of the surgeons at Texas Back Institute are leaders in this field. The first Charité and ProDisc ADRs implanted in the United States were performed by Texas Back Institute spine surgeons. Many U.S. spine surgeons, both orthopedic and neurosurgical specialists, have been trained directly by Texas Back Institute surgeons. Since performing the first ADR in the United States in 2000, Texas Back Institute has performed more than 1,400 ADR procedures with 14 types of devices.

How should I decide if surgery is right for me?

It depends on your diagnosis. For some conditions, such as infections or fractures, surgery may be the only treatment option. For most other conditions, like herniated discs or sciatica, conservative care treatment, including medications and physical therapy, is the first treatment option. If physical therapy and injections do not work, patients may need a spinal injection. At Texas Back Institute surgery is always a last resort. At each step along the way, we reevaluate the patient and the effects of the spine pain on function and lifestyle. Once the patient gets to an acceptable level of pain and function, we slow down and hopefully the patient continues to get better.

I have off-and-on episodes of back pain, sometimes mild and sometimes pretty bad. I’ve put off seeing a doctor because I’m not sure what to expect, and I don’t want to have surgery. What are my other options?

Contrary to common belief, very few back pain patients go on to have surgery – in fact, only a small percent need to have an operation. Generally, a Texas Back Institute doctor will examine you and take your history. If serious problems such as tumor or infection, which are rare, are ruled out, most patients receive care in the form of medication, physical therapy, and education about activities to reduce and/or prevent back pain. For many patients, this course of treatment provides acceptable relief. If significant pain persists, the doctor may order a scan or other diagnostic tests to help determine where the pain is coming from. Injections into different areas of the spine (epidural injections, facet joint blocks, nerve root blocks) may be needed. If you have significant leg pain, one or more epidural steroid injections may be done to reduce painful inflammation around nerves in your back that pass into your legs. Surgery is generally not considered an option until after non-operative treatments have failed. Remember, the majority of spine surgery performed to treat pain is elective. That is, it is always your choice whether to have surgery, and only after you and your doctor have discussed options and potential risks.

* The information contained on is neither intended as rendering medical advice nor as a substitute for seeking professional medical assistance. No relationship between Texas Back Institute and its practitioners may be created through Please keep in mind that, although we operate within a secure environment, Texas Back is not responsible for the security of information transmitted via the Internet. For any individual with specific questions regarding their individual health or treatment options, he or she should contact Texas Back Institute and schedule an appointment.