4 Central Peninsula Hospital Spine conditions can be complicated, causing neck, back, leg and arm pain along with numbness, tingling and even weakness. Many patients are confused about whether they need surgery after seeing their physician, surgeon, chiropractor or pain doctor, or therapist. They might ask: ● What surgery—discectomy, laminectomy, fusion, disc replacement? ● Who should do the surgery? ● Would it be neurosurgery or orthopaedic spine surgery? ● Do I even need surgery? ● My neighbor had injections and has no pain. Would that work for me? ● My dad had spine surgery and can’t walk anymore. Could that happen to me? ● My co-worker had neck surgery and was back at work the following week. How soon will I be able to work again? Get a second opinion Getting a second opinion can help patients understand that surgery is needed—or why surgery is or is not an option. Spine problems are not all the same, and what may be best for one patient with spinal stenosis may not work for your spinal stenosis. Likewise, the disc herniations that a radiologist notes on your MRI report do not necessarily need surgery. MRI reports vary significantly with the radiologist performing the reading and often describe things unrelated to neck or back pain, or sciatica. Sometimes things that are causing pain are found by the surgeon reviewing the images themselves. With all of the findings listed on an MRI report, how does a patient understand which spinal operations are performed or offered, and how can patients be sure which is best for them? If you’re not sure what to do with this, there are specialists to consult, including orthopaedic spine surgeons, neurosurgeons, pain specialists, and physical medicine and rehabilitation physicians. According to one study, almost 60% of second opinions differ from the first. Variations in training, time between opinions, and symptom onset can cause opinions to differ. A second opinion should include a review of a patient’s medical history, imaging, conservative care, and why the doctor’s opinion is similar to or differs from what another physician has suggested. Patients should not feel that they have to be rushed into surgery—true surgical emergencies that require surgery today or tomorrow are extremely rare. Surgery may still be recommended for conditions such as herniated discs, stenosis or deformities; however, a different approach may be possible. Seek a SECOND OPINION It’s a crucial step for informed decision-making about spine surgery
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