[GJZH]

Second Opinion on Spine Surgery: Rude or Smart?
Second Opinion on Spine Surgery: Rude or Smart?
Kamiah A. Walker
Medical Writer
SpineUniverse
Wheaton, IL

"Would it be all right if I got a second opinion?"

Most people don't dare to ask that of their spine surgeon. After the doctor recommends surgery to help relieve back or neck pain, patients may want to ask if they can get a second opinion…but few actually do.

Perhaps it feels disrespectful—the surgeon clearly knows what he's talking about, and it would seem insulting to second guess him.

But asking for a second opinion isn't second guessing; it's actually being a first-rate patient. It's taking a very active role in your treatment and recovery.

Spine surgery is a major operation, and deciding whether or not to have it is a very personal decision. Yes, the surgeon can recommend surgery, but the final go ahead comes from you. To help you make your decision, you should be as informed as possible. That includes asking your surgeon as many questions as you need to fully understand the procedure.

Beyond asking your surgeon questions, you can and should ask another surgeon for a second opinion.

There's one basic reason for that: in spine surgery, there are often different procedures or different approaches to treat the same condition. Your first surgeon may recommend traditional open back surgery, believing it will give him the best result. The second surgeon may recommend a minimally invasive approach, believing that a smaller incision will help him achieve the best result. It's essential for you to understand your options.

It's not that one surgeon is wrong and the other is right. It's that there are various ways to handle your pain, and it's important that you take an active role in figuring out the best option for you.

After getting a second opinion, you can talk to your first surgeon about what you learned. Discuss the pros and cons of the different options. Ask more questions if you need to. And when you're ready, you can make your surgery decision with confidence because you have been an involved patient.

Even with these reasons for asking for a second opinion, it can still be frightening to say to your spine surgeon, "Would it be all right if I got a second opinion?"

Really, don't worry about offending your surgeon by asking that question. As Dr. Chris Shaffrey, Professor of Spine Surgery at the University of Virginia, explains, "I enjoy having patients who are eager and interested to fully understand their pain and their treatment options. Honestly, I'm happy when a patient goes for a second opinion because it means that they're very serious about their treatment."

Your surgeon should respond like that. If he doesn't—if he perhaps even gets hostile—that might be a tip off that he's not the right surgeon for you.

So if you want it, go see another surgeon about your pain and possible spine surgery. In everyday life, you get a second opinion about the new car you want to buy, your haircut, and what movie to see…so when it comes to this very important decision about your body, it's a smart idea to get a second opinion.

[Bobbi]

Thanks for posting this. I know, for me, internal alarms would sound if a surgeon or other specialist downplays the importance of attaining more than one opinion.

My thoughts lead me to think that the surgeon should invite such an approach by patients. Not only might a second and, possibly, a third opinion validate the first opinion, it could also provide reassurance and bolster confidence.

Some times, too, the "fit" or rapport between a patient and specialist just doesn't "feel" right. I say, listen to that feeling. It's there for a reason.

[Pabloh]

I agree with you both, GJZH and Bobbi.

I would ask for a second opinion or maybe even a third opinion so that it backs the diagnosis up and gives a more thorough check of the particular spinal condition. You can then be sure that the choice you make after being given the list of options is the right one for you and will acheive the most positive outcome.

[LizaJane]

I'm having a helluva time collecting opinions. So far I've seen 3 spine surgeons in NY. One has kept to his position for a year now: surgery is elective; but if it was him, he'd do it. He has no idea what my future without surgery is. Second surgeon: Three opinions so far: 1st, agreed with surgeon #1, 2nd visit felt surgery was urgent, as a loose screw could break a pedicle, 3rd visit, denied he said that, essentially, and said surgery is elective. Surgeon #3: agrees, it's elective, but only in terms of when. Says eventually I will be in such pain it will be unavoidable. Return discussion with #1: He disagrees about the pedicle, he disagrees with surgeon #3.

All three want to do the highly invasive open back and then anterior procedures, a good 360. Only one has given me a good way of making the decision.

I feel I'm about to get labeled as doctor shopping. Unbeknownst to me, all these guys talk to each other. So, surgeon #1 emails me: Surgeon #3 just called to tell him he'll be operating on me. Surgeon #1 reminds me HE trained surgeon #3.

I just want two surgeons to tell me what to do and agree. Oh, I can add on theMayo clinic; they wanted to do the same procedure, but also said nothing about the consequences of not doing it. It's "elective".

That word "elective" is driving me nuts. The word driving me nuts next to "elective" is "lifestyle". This is a "lifestyle" decision, they say; only you can make it.

I'm on the schedule of #3 for June, but am still ambivalent. I just want to be told what to do in the old-fashioned paternalistic way.

Originally Posted by Pabloh

I agree with you both, GJZH and Bobbi.

I would ask for a second opinion or maybe even a third opinion so that it backs the diagnosis up and gives a more thorough check of the particular spinal condition. You can then be sure that the choice you make after being given the list of options is the right one for you and will acheive the most positive outcome.

[GJZH]

LizaJane,

I think I have said this before, but if not...let me just say this....Almost all spinal surgery is "elective."....UNLESS....you are in danger of paralysis, cauda equina, life threatening situation...etc...You get the picture...then in most cases surgeons will state that the surgery is elective...I do not know why it is this way...but maybe it is because the outcome of spinal surgery is not 100% effective so for that reason maybe it is deemed "elective." Few people come out of a spinal surgery and feel they are helped by the surgery 100%. There is usually still some problem that has not been resolved for some reason...It is not an exact science...Unfortunate, but that is just the way it is...