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2 docs 2 different opinions-new here please advise

sabinadssabinad Posts: 10
edited 06/11/2012 - 8:46 AM in Neck Pain: Cervical
Had a car accident in Nov. 09. Since then I have pain, numbness in shoulders and tingling down my arms. MRI results follow:
1. Some diffuse congenital canal stenosis.
2. Severe central canal stenosis at c4-c5 level, secondary to central disc protrusion and bilateral posterior osteophytic changes. Questionable cord compression centrally. There is bilateral foraminal compromise.
3. Central and right sided disc protrusion of c5-c6 with moderate to severe central stenosis and right sided foraminal compromise.
4. Central an right sided disc protrusion of c6-c7 with moderate central canal compromise. No foraminal stenosis.

I tried physical therapy and take many pain meds, that hasn't helped. My doc suggested a neurosurgeon.

First opinion, neurosugeon recommended fusion c4-c7. He gave me my options, explained the proceedure, asked if I had any questions, shook my hand and left the office.

For my second opinion, I decided to call the head of neurosurgery at a major teaching hospital. When I got to his office I was told the doctor was on vacation and that I would see the PA,when the doctor got back, he would consult with the PA and then I could come in for a second visit and see him. Well the PA recommended 2 artificial discs, one at c4 and the other at c7 with fusion in between for stability. He also said if it were up to him, he would put me in a "collar" right now. He didn't give me a collar. He then went on to say that if I had any trauma to my neck I could be paralyzed!! Talk about scary!

When I went back to the first neurosurgeon I asked about artificial discs. He said that he could not use them because you can't use artificial discs on more than one level.

I like the idea of the artificial discs because of the mobility factor but can't help thinking that the PA was just a little too over enthusiastic. I'm also afraid that because it is a teaching hospital that I could be used as a guinea pig for the new residents to practice on. Reminds me of Grey's Anatomy!

I tend to believe and trust the neurosurgeon that didn't try to scare me into surgery and I'm wondering if it's even worth going back to meet with the actual doctor from the second office when he returns from vacation.



  • My personal opinion is that I wouldn't have a doctor who has his PA plan his surgeries while he vacations. That's really terribly bad form- that and wasting your time by not warning you ahead of time.

    But you could always get a 3rd opinion to balance the 2 you've gotten, since the 2nd was pretty useless.
  • PA's are just that, PA's. Most are not specialists of the spine. Like HB said, it is pretty bad form for a Neurosurgeon to have a PA make the surgery decisions for him while away.

    Also a 'ditto', see about a 3rd opinion to see what that discussion is. I hope you have answers soon. Welcome to Spine Health!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • So happy I found this site, it's been very helpful. I am still wondering however if the artificial discs can be used on more level, anyone know?
  • Maybe post under surgery and ask whether anyone has had it done? No doctors here, but lots of surgery veterans :)
  • dilaurodilauro ConnecticutPosts: 9,842

    For a Spine-Health Site introduction, Click on :

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    The Spine-Health Web site offers so much more than these Member Forums.
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    Please remember that all information you receive from members on this forum is NOT
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    To get back to the Forums, you can always click on Forum Home

    lease feel free to contact me at rdilauro@gmail.com or send me a message
    Any time you get different views from two doctors,
    its always is wise to seek a third opinion. You want to make sure that at least 2 out of 3 doctors come up with the same analysis of your condition and the recommendation actions.

    Don't sell PA's short. A lot of this depends on where you live. In many major city hospitals, the Physical Assistants are well qualified, do assist in surgical decisions and may be involved with the actual surgery.

    Now, I wouldn't want to make any final decision if it was to come only from a PA.

    For more information regarding details about artificial discs, please look at:

    Artificial Disc Replacement

    Besides many detailed articles, there are a number of featured videos that illustrate the various types of artificial discs.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I agree with Ron's opinion of PA's, I've seen many great PAs. But my first visit to a new doctor, I would want to know if I'm seeing the PA instead. I think it's bad form to make an appoinmtent to see "Dr. X" and get his PA instead with no notice.

    OTOH, I've seen PAs in the place of doctors many times happily.

    And if I'm going to get surgery, I want to see the surgeon, not his PA, for the surgical evaluation. I'd be annoyed, just as you were, if I got there and the surgeon was nowhere to be found. Interestingly, I've only heard of it happening at major university hospitals where they are doing a lot of surgeries- so maybe those surgeons are more experienced, but to me the process of getting to surgery would be too stressful.

    On the other hand, you could probably get lots of individual attention from a surgeon who does only one surgery a year, but is that who you want to go with? It's all a balance ;)

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