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Second opinion?

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:26 AM in Back Surgery and Neck Surgery
Should I get a second opinion?

I know everybody says always get a second opinion. But I think my case is pretty straight forward.

I have had over a year of conservative treatment which has failed, other than medication. I've had an MRI and discogram which has given me the diagnosis of L4/L5 and L5/S1 DDD, no disc herniation or stenosis (no pressure on nerves, visible on the MRI).

My surgeon has recommended 1) two level ALIF, 2) two level minimally invasive TLIF, or 3) hybrid surgery with TDR @ L4/L5 and ALIF @ L5/S1.

I had a very good feeling about this surgeon. He did fellowship training in spine surgery, and has done residencies in both orthopaedics and neurology. His specialty is spine disorders.

I don't feel like another surgeon would have anything different to tell me. They may prefer a different disc replacement type, or maybe suggest 360, but I can't see that they would really have a totally different treatment recommendation. Is it really necessary to go for a second opinion?
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13

Comments

  • I go by my gut feeling and if you have faith in your instincts then you are probably OK- but this said-your operation is very complex and another opinion is usually warranted for a complex operation.

    I got three opinions the second time (this time) because I didn't like what the first neruosurgeon was telling me and I was right. I found a less invasive operation for my problem. I just had a gut feeling about it.

    The first time I got 2 opinions. Once again my gut feeling told me the 1st neurologist wasn't making sense. I was right-he was totally off base with his diagnosis.

    I am not a smart person-but I try to know my body and learn everything I can about my condition. I want to be a partner in my diagnosis and treatment. Good luck to you and I hope you have a complete recovery!
  • :) why take a chance and later say "i should have gotten that second opinion?" :? you are dealing with surgery, cutting yourself open! it seems like you should do ALL you can to make sure your surgery and recovery is successful. :T part of this is getting that second opinion!! what can it hurt to have his opinion agreed with or not. then you can go into surgery feeling fairly secure that you are doing the right thing. why put so much power into one man's hands? this is your body!!! Jenny :)
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  • My boss (a physician) recommended that I get a second opinion from a neurosurgeon (the first one is an orthopaedic surgeon). One of the other physicians in the lab also agreed, and said he would email a neurosurgeon and cc me on the email. So, I may be able to get a second opinion without paying my copay and having to get an appointment (not that that is the reason I wouldn't go for a second opinion).

    They said even if there isn't a question about the diagnosis, that it's good to get another opinion on the prognosis. And that makes sense.
  • Surgeons are like anything else. There are good ones and there are not so good ones.
    I consulted with no fewer than 8.
    Let me tell you, a couple of them seemed like really great surgeons, but when I did some investigating, found out they weren't.
    It may have cost me a few extra bux, but it was worth it to get the different opinions.
    It was important that I not tell each one what the other had said so as not to influence.

    Please don't short-change yourself. What you are proposing is a very intense operation. Get a few other opinions.
    -----------------------------
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • It never hurts to get a second opinion, but that is a decision you need to make for yourself (unless your insurance requires it).

    I didn't get a second opinion and do not regret it. I walked into the surgeon's office saying to myself, I'm ready for anything, but if he says fusion, I'm getting a second opinion.

    I had educated myself ahead of time, including seeing some MRI images online of different spinal issues. As we looked at my MRI, I could clearly see that the disc space had already partially collapsed - when taking the time to study the MRI, I didn't need a surgeon to tell me that something wasn't right with that disc - it was obvious. I knew my only options were:

    1. Discectomy now, fusion later

    2. Disc replacement

    3. Fusion now

    I decided to go ahead with the fusion because its current 95% success rate in the US is better than disc replacements. Add to that, many successful disc replacements are re-done in 5-10 years. I also figured it would be better to let someone mess with my back once instead of twice.

    My surgeon has 28 years of experience and I felt really good about putting myself in his hands. He recommended fusion surgery, but told me I could call his secretary to schedule the procedure when I was ready for it. He said that would give me time to think about my options and possibly get a second opinion.

    Maybe my comfort was due to his not pushing me into the fusion. He gave me time, several options and had no problem with my getting another opinion.

    Should I have gotten a second opinion? Perhaps, but I'm not going to second guess myself now, and I am still comfortable with my decision not to do that.

    Let your conscience be your guide.
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  • A friend had ACDF surgery by one surgeon who totally blew it. So he had it repaired by the surgeon I chose (before I chose him) and was very, very impressed. So he recommended him to me. I read up on him and when I had my first meeting, I too was impressed and knew he was the right surgeon for me right then. I have since learned that he has a passion for cervical surgeries and is also on SH referral list. Sometimes you just know.
  • I chose not to get another opinion. I did research quite a bit though and went through 7 years of conservative treatments and therapies to no avail. I basically made the choice to go with fusion after my discogram was done. It was very conclusive that my discs were causing the pain. Go with your gut though. I fired the NS prior to the one who actually did the surgery because my intuition told me to. I do not regret the choices I have made.

    One Love,

    Stephanie
  • Thanks for responding folks.

    My surgeon also was not pushing me, in fact said that I could probably wait for up to a year.

    I am still reading, researching and thinking. And I need to discuss a lot of things with my boyfriend. I also have a list of questions for the surgeon, and hopefully he will call me back next week, though I guess with the holiday's I shouldn't expect an immediate call back.

    But it's good to hear that not everyone is saying absolutely, positively "You need to get a second opinion!". It makes me feel 'not so bad' about thinking I may not want to bother. I really do think that as long as you do your research, and feel good about your decision, that's all that matters.
  • Hi Cathy, I did not get a second opinion either. But, only because by working in the hospital where my NS practices, I was able to get the inside scoop on him. In fact when I was initially referred to someone else, I called a nurse friend who works Neuro ICU, and she told not to go to that other NS and recommended my surgeon or his partner. I called my PMD and got my referral changed. I also inquired of nurses who work in surgery, recovery, neuroscience, and even risk management, and they all said my NS was the best. We do not even have an ortho at my hospital who does spines, so that was never a consideration. I did think of going to UCSF for a second opinion, but the commute was going to be a problem in the long run, so nixed that idea. Good luck with whatever you decide. This surgery is definitely a huge commitment, and you need to feel confident with your decision. >:D< Cali-Sue
  • I'm probably in the minority in my thinking here,but I would stick with conservative treatments as long as possible and put off surgery as far into the future as was safe to do~if I could control my pain.

    But that's just me :)))
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