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Which surgeon's opinion do I trust?! To have surgery or not to have surgery....

that is the question! lol

About a month ago I was told by a neurosurgeon and an orthopedic surgeon that I needed an ACDF to fix the instability in my spine (specifically between C5/C6....My C6/C7 are fused because of a birth defect) I had been in an accident, and due to that accident there was a ligamentous injury...an interspinal ligament. There was no compression on my spinal cord at all...in the MRI I had done, my spinal cord was totally fine. There was extra space on the posterior side between C5/C6, but no subluxation (sliding backward or forward).
I had a LOT of pain for about three weeks post-injury, but then that sharp pain went away. Occasionally I get tingly feelings down to my shoulder blades and my right arm, but no real weakness or anything. Anyway, those two surgeons said surgery was my ONLY option or I could get paralyzed or die thanks to one wrong move. The first surgeon I saw put me in a Miami J neckbrace and said to wear it 24/7 and put me on tons of restrictions.

I asked my primary care doctor to refer me for yet another opinion, at a large university-affiliated research hospital, and got an appointment just yesterday with the Co-Chief of Neurosurgery there. He's an expert in cervical instability and spinal trauma. He looked carefully through my scans from the day of the accident and a month after. He took new xrays yesterday (2 months post-accident) and did a neurological exam on me as well. He quickly concluded that I DO NOT need surgery, that because C5/C6 aren't shifting forward or backward in my flexion/extension xrays, that I have no cervical instability. He actually chuckled a little when I told him I had been wearing a neckbrace 24/7 for a month. He said I probably needed it for a couple weeks post-accident, but I was fine to go without it now.

Sooo....2 surgeons say YES SURGERY NO OTHER OPTION....1 surgeon says NO WAY SURGERY WOULD BE IRRESPONSIBLE (his words).

Who do I go with??? My husband wants me to go to yet another large university-affiliated research hospital (we're in NC near the Triangle) and get a 4th opinion from another expert. I'm just ready for this all to be over!


  • SukhreSSukhre San Diego, CAPosts: 181
    It looks like they push the decision to the patient. You can show it to another surgeon,, send your MRI to out of state famous surgeons.
    MRI shows C4-C7 severe steonosis. Pain in hand.
  • I'm kind of in the same position myself at the moment, so I feel your pain. I have a large L5-S1 disc herniation but the pain is currently at a much, much lower level than it was a month ago. First doctor said I *need* surgery because of the risk of developing cauda equine syndrome. I just got a second opinion from a university affiliated physician and he said that risk is very small, so surgery is not required and the decision to have or not have surgery is up to me. I'm going to get a third opinion since the information is so conflicting,

    Good luck, and I hope you can quickly come to a consensus as to the best course of action!
  • Ice manIIce man Posts: 123
    edited 07/13/2015 - 1:59 AM
    I agree with your hubby. See one more. If a surgeon with that much experience said no then there is no way anyone would be doing surgery on me.
  • franklinkeckfranklinkeck Posts: 1
    edited 07/22/2015 - 3:24 AM
    You must go to the best surgeon's advice, How about travelling? My wife got a Spine Surgeries in India, with the help of Placidway, a medical tourism company. We were referred by this company to [edit] Hospital which is a modern and highly specialized medical center. My wife did not have so much difficulties in undergoing the surgery since the staff were so kind to us and made my wife comfortable.

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  • You will have to own the decision - bottom line. For me - my decision to proceed to surgery ( in the face of balanced opinions from multiple surgeons advocating for and against intervention) was a risk based assessment. What are the risks of incurring permanent/catastrophic damage to the spinal cord and peripheral nerves based on random change or my daily activites vs surgical risk (itself a combination of many factors including nature of procedure, surgeon skills, ect). In the end the risk determination weighted in the direction of surgical intervention - now I sleep well knowing that I no longer live with an elevated possibility of catastrophic damage to my spinal cord.
  • dilaurodilauro ConnecticutPosts: 9,875
    it is always wise to seek second, third and if necessary fourth opinions.

    You want to have at least two doctors that agree on your condition and agree on the action plan. When there is disagreement, than you should seek a third opinion.

    In the situation you described, the two doctors are miles apart . One from scaring you to say you might get paralyzed if you move the wrong way, to the other extreme in saying surgery is not required. Those are two way different analysis of your situation. Too far apart.

    Plus, the one doctor you mentioned did an X-ray. That really isn't the diagnostic tool to determine the degree and severity of any spinal disc problem. Only MRIs can pinpoint the problem. And many times additional tests are required afterwards.

    So your scorecard so far is:

    • - One doctor indicating that you could Die or become paralyzed with one wrong move
      - Another doctor putting you in a neck brace with restrictions
      - The third doctor indicating that you do not need surgery
    That analysis is all over the board. Doesn't seem to be any consistency in what the doctors are looking at. Its almost as if they are all looking at different diagnostic test results and different patients.

    Get that fourth opinion. It doesn't always have to come from a big name research hospital. In fact, many times, seeking a teaching hospital where the residents, interns and doctors are eager and up to speed with research might be the best choice

    Bottom line, you want some answers that make sense. Not knowing or worse having conflicting opinions can make things much worse on you, both physically and emotionally.

    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
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