Millions of Americans need treatment for lower back pain and sometimes surgery is the only option. But, a Boston hospital is now giving patients a choice about how that procedure is done. “I had a 55-minute drive to and from work,” Dale McClanan said. “When I got to work, walking into the building and up the stairs was quite painful.”For McClanan, the solution for his pain was spinal fusion. He’s had the procedure done twice. The first time, seven years ago, was under general anesthesia. The second time, just seven months ago, he was wide awake.”I only remember, like, sitting down in a chair and they had me, like grab a bar,” he said. “And they rotate you over. I was awake through the whole thing.”Dr. James Kryzanski has done hundreds of those procedures at Tufts Medical Center in Boston. He said, while the option may sound scary, it’s very similar to the process used for a knee replacement or even a cesarean section. “You get a spinal tap. And we give just a small dose of a local anesthetic into your spine,” he explained. “That gives you about three hours or so of numbness from the area of the injection down.”Kryzanski said there are other benefits. “The surgeries under spinal go faster, smoother and with less blood loss than the same operation under general,” he said. Tufts data shows patients spent less time in recovery and less time in rehab with the “awake” surgery option.”I would almost say it was half of the impact that I had before,” McClanan said. “It gives you a remarkably quick bouncing back. And I would say within six weeks, it was like it never happened.”Kryzanski said the “awake” option is available to any patient requiring a spinal fusion. The only exceptions are people with scoliosis or a lot of anxiety.