Your Surgical Journey: From Consultation to Recovery

Your Surgical Journey: From Consultation to Recovery

What to expect at every stage, from your first consultation until you get back to your life

Dr. Ernesto Martínez de la Maza
Neurosurgery • Spine Surgery

Knowing what to expect eases the uncertainty

Deciding to have spine surgery raises questions and, above all, uncertainty about what is going to happen. That is why I want you to understand every stage of the process, from the moment you walk in for your first consultation until you get back to your life.

Knowing the whole path lets you take part in every decision and go into surgery feeling calm and confident.

Your journey, step by step

Eight stages we go through together, from your first consultation to your final discharge

1

First consultation and evaluation

At your first appointment, I listen carefully to your story — how the pain started, what makes it better or worse, how it affects your daily life — and perform a complete neurological exam(strength, sensation, reflexes and gait). The goal of this stage is not to operate, but to understand your problem and rule out warning signs.

No commitment
2

Diagnostic tests

To see precisely what is going on, I order the imaging studies that fit your case: an MRI, a CT scan and, when stability needs to be assessed, flexion-extension dynamic X-rays. These let me confirm the diagnosis and, if needed, plan the surgical strategy.

3

A personalized treatment decision

Surgery is not always the first step. Many spine conditions improve with conservative treatment, and I only recommend surgery when there is a clear indication or when non-surgical care has been exhausted. If surgery is the best option, I explain why, which technique I propose (open or minimally invasive) and what results to expect. You make the decision with complete information.

You decide
4

Getting ready for surgery

Good preparation makes surgery safer. At this stage we complete your lab work and pre-operative evaluation (and, depending on your case, evaluations by other specialists), get other health conditions under control, such as blood pressure or blood sugar, and adjust any blood thinners. If you smoke, quitting well ahead of time improves healing and fusion. I also give you clear instructions on fasting and what to bring on the day of surgery.

5

Surgery day

On the day of surgery we work with a complete team. The procedure is performed under general anesthesia, with a surgical microscope and intraoperative neuromonitoring — real-time monitoring of nerve function — to protect the spinal cord and nerve roots throughout the procedure. Depending on your case, the approach will be minimally invasive, through small incisions, or open.

Neuromonitoring Surgical microscope
6

Your hospital stay

After surgery, the focus is on your safety and on getting you moving soon. We encourage early mobilization, manage pain with a multimodal approach and closely monitor your neurological progress. The length of your hospital stay depends on the procedure: it is usually shorter after minimally invasive surgery and somewhat longer after open surgery or in complex cases.

7

Recovery in stages

Recovery is gradual, and I am with you through every phase: in the first few weeks, wound care, suture removal and initial restrictions (no heavy lifting, no twisting, no driving at first); then progressive physical therapy to rebuild strength and mobility; and later, your return to activity, first to light and desk work and then to physical work, depending on your progress.

Guided physical therapy
8

Long-term follow-up

Discharge is not the end. We schedule follow-up visits and, when there was a fusion or instrumentation, imaging studies to confirm that everything is healing as expected. My commitment is to stay with you until you are back to your life with confidence.

Ongoing follow-up

Questions about your surgery?

Most can be answered in an evaluation. Learn your diagnosis and all of your options, not just the surgical one.

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Frequently Asked Questions

  • What is the fundamental difference between open and minimally invasive surgery?

    The key difference is not what we do, but how we reach the spine. In open surgery, a longer incision is made so the muscles can be moved aside, giving a direct, wide view of the area being treated. In minimally invasive surgery (MIS), very small incisions are used and a system of tubes is passed through the muscles so we can work without cutting them, guided by cameras, microscopes and advanced imaging systems.


  • Can one technique be called "better" than the other?

    No. The best technique is the one that is safest and most effective for your specific problem. It is not a contest between "new" and "old." Open surgery is the gold standard for complex cases such as severe deformities or large tumors. MIS is an excellent option for more localized conditions such as herniated discs or stenosis at one or two levels. The best surgery is the one tailored to you, not the other way around.


  • How do you decide which type of surgery is right for me?

    This decision is made during your consultation, after a thorough review of your case. We consider three main factors:

    • Your diagnosis: What specific problem do you have? Does it affect one level of the spine or several?
    • How complex the condition is: Is it a simple herniated disc or complex scoliosis that requires major correction?
    • Your anatomy and overall health.
    • We will explain, with complete transparency, why one approach is the most appropriate for you, making sure the choice is always based on your safety and on how effective the treatment will be.

  • Are the long-term results equally effective with both techniques?

    Yes. When the procedure is properly indicated, long-term results are equivalent. The goal of relieving pressure on a nerve or fusing a vertebra is achieved just as effectively with either method. The big advantage of MIS lies in the short-term benefits: a faster, more comfortable initial recovery.

  • I have heard that recovery after MIS is faster. Is that true, and why?

    Yes, it is true. Initial recovery is noticeably faster with MIS because the back muscles are preserved. Since the muscles are not cut, there is less post-operative pain and less bleeding, and patients can get up and move around much sooner. This means a shorter hospital stay and a quicker return to everyday activities.

  • For which spine problems is open surgery essential?

    Open surgery is still the best option for:

    • Correcting severe deformities: Such as adolescent or adult scoliosis.
    • Complex revision surgeries: When an area that has already been operated on needs another operation.
    • Large spinal tumors: Which require a wide surgical field to be removed safely.
    • Severe trauma: That has made the spine highly unstable.

  • Are the risks different between open surgery and MIS?

    The risks inherent to any spine surgery (such as neurological or implant-related risks) are similar, and they are minimized with technology such as neuronavigation and monitoring. However, some risks do vary: open surgery may carry a higher risk of bleeding or infection because of the size of the incision, while MIS, by preserving the muscles, reduces these specific risks.

  • Will there be a big difference in post-operative pain and scar size?

    Yes, this is where the difference is significant. Post-operative pain is considerably lower with MIS because there is minimal muscle trauma. As for the scar, open surgery leaves a single line down the middle of the back, while MIS may leave one or several very small incisions, which look much better.

  • How much do the hospital stay and the return to work change?

    The change is notable. For comparable procedures (for example, a one-level fusion), an MIS patient might be in the hospital 1-2 days and return to an office job in 2-3 weeks. With an open approach, the stay might be 3-5 days, and returning to work could take 4 to 6 weeks.

  • Is the same safety technology (neuronavigation, monitoring) used in both types of surgery?

    Absolutely. Our commitment to safety is the same, whatever the type of incision. In both open and minimally invasive surgery, we routinely use Intraoperative Neurophysiological Monitoring, Surgical Neuronavigation (O-Arm) and a high-definition microscope. These tools are our standard of care to ensure maximum precision and protect your neurological function at all times.