Abstract

The practice of spine surgery presents numerous ethical challenges. Ethical considerations must be taken into account throughout the patient’s treatment, from the surgical decision to the final follow-up. Surgical decision-making can vary for many common degenerative spine conditions. This variability may be due, in part, to the fact that clinical and radiologic data are not uniformly correlated. Such variability could be a source of confusion for patients. It is imperative that the treating surgeon explain the nature of the problem to the patient, respect the patient’s autonomy, and tolerate the patient’s hesitation in deciding to proceed with surgery or adequately deal with their desire to have surgery when it is not indicated. Nonsurgical treatment options should be offered along with their potential benefits. When the results of surgical intervention have been suboptimal, surgeons should avoid depressive and ethically problematic terms such as “failed back surgery syndrome.” Further scientific and technological advances should be sought and investigated to develop treatment solutions. With advances in operative technology, the surgeon often works with the medical industry. The surgeon should follow ethical principles, rules, and regulations when dealing with the industry to avoid bias or conflict situations. If the surgeon is unable to perform surgical treatment, he or she should offer the patient alternatives that could help improve their medical condition or alleviate their pain, as the patient remains at the center of treatment.