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How can my father get the spine surgery he needs now?

The Question

My father was injured more than a decade ago and had back surgery to remove 2½ shattered discs. For months, he's been in overwhelming pain, can barely walk, can't sleep or sit. Five months ago, MRI results were sent to a surgeon. Since then, he has twice gone to emergency with intolerable pain. There, one doctor told him he needed surgery immediately while another agreed an operation was needed but to wait for the specialist. What can he do to get surgery?

The Answer

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Wait times for spine operations are some of the longest in Canada, so lengthy, in fact that some surgeons have closed their practices to new patients. About 90 per cent of patients referred to spine surgeons are not candidates for an operation, creating a terrible logjam for those remaining 10 per cent who do need surgery.

Most patients who see spine surgeons later learn they need non-surgical help including specific exercises, physiotherapy or education. A better triage system is needed to ferret out those who require surgery from those who don't, but until then, patients fritter away their time and tax dollars for unnecessary medical imaging.

Albert Yee, co-director of University of Toronto's spine program, had some good advice on how your father can move through the system more efficiently.

He suggested you go with your father to the family doctor and bring the discharge summary from emergency with you because the physician may not have yet received it. Tell the physician your father went twice to emergency and ask if he can send an updated referral to the surgeon, with more current information as it sounds as if your father's condition has deteriorated.

"He needs treatment and an assessment," said Dr. Yee, a spine surgeon at Sunnybrook Health Sciences Centre and associate professor of surgery at University of Toronto. "It sounds like he can barely walk and it is quite important to relay that to the specialist."

Given that spine surgeons receive dozens of new referrals a week – Dr. Yee receives at least 30 – an updated referral will help your father stand out. That, hopefully, will translate into a shorter wait time.

If your father ever goes back to emergency, see if you can get the emergency physician to send an updated referral to your father's surgeon or make a telephone call, fax or e-mail.

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This is more of a courtesy – not something emergency physicians are obligated to do – so ask carefully and politely.

It may also help to go to the family doctor with the discharge summary in hand in the hope of the physician sending in an updated referral to the surgeon. Also, see if you can get the emergency doctor to advocate on your behalf by sending in an updated referral, a courtesy call, e-mail or fax to the surgeon.

This must seem a terribly onerous process but it takes a lot of advocacy to break through this health care logjams.

The Patient Navigator is a column that answers reader questions on how to navigate our health-care system. Send your questions to

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