Top Neurosurgeon Warns Patients Against Rushing Into Spine Surgery

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Dr. Robert S. Bray, Jr. of the DISC Sports & Spine Center offers tips for determining when surgery is appropriate or not.

I often see patients after other doctors have told them they need major, scary sounding spine surgeries…that they risk danger if they don’t do it right away. That’s exactly when they should seek a second opinion.

According to Dr. Robert S. Bray, Jr., a pioneering neurosurgeon and founder of DISC Sports & Spine Center (DISC), many Americans are being urged into spine surgeries they don’t really need. He further notes that nearly 80% of his own spine patients are able to improve their cases without surgery, by undergoing a well-managed regimen of conservative therapies.

“I often see patients after other doctors have told them they need major, scary sounding spine surgeries…that they risk danger if they don’t do it right away. That’s exactly when they should seek a second opinion,” says Dr. Bray. “Patients should be given a clear reason for surgery vs. conservative care, and then they should be able to consult another specialist before making that decision.”

Dr. Bray also recommends that any patient considering spine surgery for neck or back problems consider the following important indicators:

1. Is there progressive neurological damage? If a patient has documented spinal cord compression and is developing myelopathy, this is an injury that does not heal itself, so the damage can be irreversible. Symptoms include imbalance, numbness in the hands or feet and jumpiness or spasticity, which may or may not be coupled with pain. If a patient is showing symptoms of spinal cord compression and resulting myelopathy consistent with an MRI reading, this is a clear indicator for surgery.

Nerve compression—though different from spinal cord compression in that it is reversible—causes radiating pain in the distribution of the nerve and may also manifest itself through numbness and weakness. While less urgent, nerve compression may also cause progressive neurological damage that requires surgery.

2. Have conservative therapies failed to stop incapacitating pain? As Dr. Bray notes above, nearly 80% of his patients are able to improve their cases through conservative care, with surgery indicated only when other methods have failed. They have actually been able to find relief from incapacitating back or neck pain through techniques like soft tissue therapy, interventional pain management and physical medicine. For those whose pain persists despite conservative methods, minimally invasive surgery may provide a quick and safe option that eliminates reliance on heavy pain medication.

“I established DISC with this in mind – to create a truly multidisciplinary environment in which patients could not only explore the range of conservative care options, but also be well-informed advocates of their own surgical care should they need to take that route,” Dr. Bray explains.

3. Does this injury have persistent, lifestyle-altering flare-ups? If a patient’s quality of life is severely impacted by repeat episodes of the same spinal injury or pain, surgery may be an option where the benefits far outweigh any risks of the procedure itself. Most spine surgeries today may be performed safely as outpatient treatments, with patients back on their feet the same evening. But, just like #2 above, Dr. Bray insists that surgery in these cases be considered an option, not a requirement.

In any case, Dr. Bray cautions patients to seek out doctors who embrace a minimally invasive philosophy: “What is the least invasive I can be with the patient to achieve the best results?” he asks himself daily. “The answer, most of the time, isn’t surgery at all, but when it is, it doesn’t necessarily have to be a major one.”

About DISC Sports & Spine Center
As the official medical services provider for Red Bull’s North American athletes, DISC Sports & Spine Center (DISC) is one of America’s foremost providers of minimally invasive spine procedures and advanced arthroscopic techniques. Dr. Robert S. Bray, Jr. founded DISC with the vision of delivering an unparalleled patient experience for those suffering from sports injuries, orthopedic issues and spine disorders. DISC’s individually picked, highly specialized physicians apply both established and innovative solutions to diagnose, treat and rehabilitate their patients in a one-stop, multi-disciplinary setting. With a wide range of specialists under one roof, the result is an unmatched continuity of care with more efficiency, less stress for the patient and a zero MRSA infection rate. DISC’s ambulatory surgery centers include Diagnostic and Interventional Surgical Center and DISC Surgery Center at Newport Beach. Visit

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Garrett Bray
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