Key points from this video
- Ask the surgeon to name the exact problem the operation is intended to solve.
- Ask which symptom is most likely to improve and which symptom may remain.
- Understand reasonable nonsurgical options and whether waiting is medically safe.
- A second opinion is sensible when the diagnosis, need for fusion, number of levels, or expected benefit remains unclear.
What this video can—and cannot—tell you
The presence of degeneration, a disc bulge, or stenosis on a scan does not automatically prove that the finding is the cause of pain. The decision becomes stronger when the history, examination, imaging, prior treatment, and patient’s functional goal point to the same problem.
This is general educational information, not medical advice. Symptoms vary by person — a clinical evaluation is the only way to know what’s right for you.
Full video transcript
Don't have spine surgery. I'm a minimally invasive spine surgeon based here in Fort Wayne, Indiana. My name is Dr. Marc Greenberg, and that's still the best advice I can give you. In my personal practice, surgery isn't the first plan. It's what's left when all of the other plans don't work. Fortunately, about 90% of my patients get better without ever needing an operation. We have multimodal pain management. We have targeted specific injections. We have physical therapy that's actually aimed at the right problem, not just generic exercises. We pick the right ones for what's actually wrong with you. Most disc herniations, for instance, your body's going to end up reabsorbing. Most back pain ends up settling. Most people who walk in convinced they need surgery don't ever need an operation. And here's the uncomfortable part. If you take a spine problem to a spine surgeon, you're asking someone who's trained 14 years or longer specifically in spine surgery whether you need an operation, and that includes myself. That's not a knock on spine surgeons. It's just how expertise works, which is why the first question I ask isn't can I fix this because I probably can. It's does this need me at all? I took an oath to do no harm. Operating on someone who didn't need it is harm, at least in my mind. And it doesn't stop being harm because the operation went well or you went home or there were no complications. So, if you're sitting there with an MRI or a surgery date, and you have this knot in your stomach, slow down. Ask your ask these four things. What happens if I wait? What have we actually tried? What's the non-surgical plan? And what would have to change for surgery to be the right answer? A good spine surgeon will have answer to all four of those. And a great spine surgeon won't be offended that you asked. Me personally, I'd rather be the spine surgeon who talks you out of spine surgery rather than the spine surgeon who talks you into it.
