Some patients advised surgery may not need it, leading surgeons say

A significant number of patients who are told they need orthopedic surgery may actually be able to avoid it, according to leading spine surgeons from China and the United States.

The warning came during a joint forum in Beijing on Tuesday, hosted by China's Saint Lucia Consulting (a global medical consulting firm), Xinhua Health, and the Hospital for Special Surgery (HSS) in New York.

"About 35% of patients who come to HSS for a second opinion end up receiving non-surgical treatment," said Todd Albert, Surgeon-in-Chief Emeritus and Richard Rogers Chair to Advance Spine Care at HSS.

Surgery is not the only answer

"Don't rely on images alone," said Zhang Jianguo, chair of orthopedics at Peking Union Medical College Hospital.

"You cannot decide on surgery based solely on imaging results," he said. "You have to look at the patient's symptoms, physical signs, and functional limitations."

He noted that many patients referred to his hospital after being advised surgery elsewhere turned out not to need it at all.

For Albert, the value of international collaboration is not simply about traveling abroad for treatment, but better preoperative assessment, sharing imaging data, and expert discussions. "That helps patients decide whether treatment at home or overseas makes more sense," he said. "It reduces unnecessary referrals and wasted trips."

Complex cases need a system, not just a surgery

For challenging conditions like spinal deformities, elderly degeneration, revision surgeries, or patients with multiple health issues, the approach has to be broader.

"Complex orthopedics is not just about surgical technique anymore," Zhang said. "It's a systemic project. The more complex the patient, the more you need multiple disciplines including respiratory, anesthesia, neurology and rehabilitation working together before the surgery even happens."

New program offers fast access to global experts

Saint Lucia Consulting launched an orthopedic international care program at the forum.

The program targets patients with complex spinal and joint conditions. It offers case reviews, international second opinions, help with cross-border care, rehab coordination, and long-term follow-up.

For patients who face unclear diagnoses, conflicting opinions, or poor recovery, the program can connect them with top specialists within 72 hours, according to Cheng Xiaoyu, deputy general manager and rotating medical director of Saint Lucia Consulting.

"What complex orthopedic patients often lack," she said, "is not treatment opportunities, but the ability to make high-quality decisions at critical moments."