Back Surgery in Kyoto

My 22yr old daughter just got an MRI for acute back pain and the doctor wants to schedule surgery.

As a far-away dad, I'm looking for any experience/thoughts:

. Overall quality of surgery in Japan?
in Kyoto?

. Would you consider flying her back to US?

I'm not worried about the decision to operate, since it's usually clear when physical therapy won't help. If she has it there, I can go out for a couple of weeks to help recoup, so that's not a big issue.

Back surgery isn't complex but I know the results have a lot to do with the skill of the surgeon.

ANY THOUGHTS? thanks so much

A Japanese relative of mine recently had a successful keyhole hernia surgery. However, when she was recovering, she was prescribed rectal suppositories for pain relief, but a stupid and rude nurse made her take one of them vaginally! For the patient, this experience was extremely shocking and humiliating, but the nurse got away with it.

My own abdominal surgery in Japan was a success but it could have been avoided. What led to it was a series of blunders by the hospital staff: they nearly killed me first and then did a great job of saving my life.

In my subjective opinion, here in Japan they have good service and equipment but not enough brain power.

I'd say, take your daughter to the US for a second opinion.

I can understand somewhat where the above poster is coming from.

Japan has some of the best surgeons in the world.
However, yes, I have seen a lot of under-trained, overworked nurses. The majority of medical errors are committed by these people.

But this is true of the USA as well.

Which hospital in Kyoto?
The best surgeons are at Kyoto Prefectural Hospital (Furitsu Byoin), Kyoto University Hospital (Kyodai Byoin), and Red Cross Hospital (Nisseki). Another really good hospital is Kyoto Baptist.

I personally would choose one of these institutions for any medical need (except maybe dentistry). Each of these hospitals have recently undergone or are currently undergoing massive upgrades so they have some of the newest facilities and equipment in the country.
I would not choose a private clinic or smaller hospital because many don't have emergency medical staff or specialists in other fields in cause there are complications during or after the surgery.

Is insurance an issue? I know you can't weigh the cost of your daughter's well-being but if having her have surgery in the US would mean massive financial burden, I don't think it would be justifiable.

As for aftercare and rehabilitation, Kyoto has two top quality facilities: Yamagiwa Orthopedic Clinic and St. Joseph's Hospital. I highly recommend either of these facilities and particularly Yamagiwa. It's somewhat small and the waits are ridiculous but the man is brilliant and I'm pretty sure he has x-ray vision.

The biggest problem with the Japanese medical industry is the lack of doctors, the poor bedside manners and lack of personal and communication skills of many doctors, and lack of skilled nurses. Which could be said of most countries today.

That said, Kyoto is one of the most medically advanced cities in the world and as long as you choose the right institution and know to push your doctors for information, you have nothing to worry about.

I forgot to mention this in my previous post but you might want to consider having your daughter go to Yamagiwa (やまぎわ整形外科) before choosing a hospital and whether or not to have surgery.

He has an MRI device and can give you a viable second opinion. If he says surgery is required, he also can write a referral. Referrals in Japan aren't necessary, but it's better to have an expert recommend someone they trust.
Sometimes, referrals can mean the difference between getting the initial examination done by the head of a department versus one of the over-worked underlings.

I am a doctor and have spent 7 years in Osaka and Kyoto. I do not recommend having surgery in Japan. I have seen and heard of some very careless medical practices there. There are good doctors, but.... I would recommend Seeing a chiropractor or a "Honetsugi". Also "Spinal Distraction" that can be gotten from a Physical therapist or a chiropractor might be an option if the problem is a herniated disc. Be careful however when finding a chiropractor in Japan however, as the profession is not regulated and there are all kinds of unqualified people calling themselves chiropractors. There is actually a chiropractor in Kyoto who is a graduate of Palmer College of chiropractic. He is located on Marutamachi Street in the western part of Kyoto towards Arashiyama. You could find a qualified chiropractor by contacting Palmer College of Chiropractic in Davenport Iowa for a referral (1-800-PCC-ALUM). Good luck.
I would exhaust all forms of alternative therapy and treatment and if surgery is still necessary, I would return to the US if possible. If insurance is an issue i.e. she only has insurance in Japan, then I would seek help from the US Consulate in choosing a good hospital and a good surgeon.

I just thought of some additional information for your consideration.
Low back surgeries are frequently unsucessful. Approx. 50% failure rate.
I have experienced a "herniated disc" that was so bad that I almost couldn't walk. However, after about 15 treatments on a spinal distraction machine it got completely better. There are instances where surgery is indicated (Cauda Equina Syndrome, etc.) , but I would get a second opinion and I would also recommend that her records be reviewed by a radiologist and conservative surgeon in the USA.

In Japan, your stay in a hospital is many, many times longer than in the U.S.
For example, a day surgery in the U.S. would mean several weeks in a Japanese hospital, unless things have drastically improved since I lived there.
Another consideration is that the family is expected to spend lots of time in the hospital with you, providing much of the nursing care.

I severely injured my back in Japan working there. My doctor wanted to do surgery right away. I have a friend in Japan who is a famous doctor there and he advised me to return to the US for a second opinion and warned me to have the surgery done in the US if I needed it. I saw the best Neurosurgeon in the US and he advised against any surgery due to possible paralysis. Also, Japanese doctors do not give real pain medication to patients. Anti inflammatory medicines were the best I got, and I suffered. DON'T DO IT!