When and why you need a second opinion for spine surgery

Orthopaedics and Fitness
Doctor looking at spine X-rays in a doctor's office.

Your spine allows you to walk, move, twist — you name it. Because of how much use it gets, your spine is at risk of becoming damaged. Its importance to daily function also means that spinal injuries and conditions can be severely debilitating.

To address spine conditions, some turn to spine surgery. Spine surgery can treat a range of spine issues, including herniated or ruptured disks, fractures and degenerative disk disease, such as osteoarthritis.

But any kind of surgery, including spine surgery, is a major decision. And it can feel overwhelming, especially when you’re desperate for relief from your symptoms.

The good news is that you’re not alone in making this decision. In fact, according to Michael R. Murray, MD, a spine surgeon at Main Line Health, getting a second opinion about your spinal concerns can put your mind at ease and help you make the best decision for your body.

When should you get a second opinion for spine surgery?

Seeking a second opinion for your health care is often a good way to stay informed about your care. It helps you understand your options, consider different treatment approaches and find a plan that works for you.

According to Dr. Murray, this is especially true if you’ve been told you need a spinal fusion. A spinal fusion is when a surgeon fuses two or more vertebrae (small bones in your spine). This causes the bones to heal into one solid bone, getting rid of any pain that comes from motion and providing stability.

While spinal fusions can address symptoms from a range of conditions, including degenerative disk disease, herniated disks and other concerns, they are a major surgery.

"A fusion has the ability to alter your life a lot more than some of these smaller spine procedures," explains Dr. Murray. "It's a major, potentially life-changing procedure, and you can't undo it if you're not happy with it."

In some cases, spinal fusions are the right approach. But in others, spinal fusions aren’t the answer. "Especially with fusions, not only can the surgery not make you better, but it can set you up for future complications," says Dr. Murray. "You can actually be worse off than you started with a fusion if you don't need it"

The side effects of spinal fusions can include infection, persistent pain, nerve damage or reduced flexibility. Or, your symptoms might come back. "I think anytime you've been told you need a fusion, it's reasonable to get a second opinion," he says.

What options are there to treat spine problems?

With spinal conditions, there are a range of options to ease your symptoms — many of which are less invasive than surgery. "The first things are easy, like have you done physical therapy? Have you done [steroid] injections?" says Dr. Murray.

There are other options, too, such as implantable pain control devices. And for some patients, at-home treatment may be the ticket to relief. This includes exercise, stretching and hot and cold therapy.

If you do need surgery, different approaches may have fewer risks.

"There are some ways to perform a spinal fusion that are a lot less traumatic to the body and have a faster recovery," Dr. Murray says. For instance, surgeons can approach the spine from the side or the front of the body, which avoids removing muscles from the spine. This method can decrease some of the risks that are associated with traditional fusion surgery.

Dr. Murray also uses computer navigation to reduce risks and improve recovery time. This is called less invasive spine surgery, and it allows him to see more of your spine without the need for a large incision.

How to find the right care team for your needs

The key to any decision about your health is gathering enough information. Whether you’re considering a new exercise program, a new medication or a surgery, it’s important to remain a part of the decision-making process. According to Dr. Murray, this is called shared decision-making.

"The doctor should be saying ‘Here are the potential advantages of surgery. Here are the potential disadvantages. Here are the alternatives. What do you think?’ Good decisions are going to get made in that environment," he explains.

It’s also important to feel comfortable with your care team. "You want a physician that outlines all of those things and that you get the sense has your best interest at heart," says Dr. Murray. "Patients need to work with the health care provider that they think is giving them realistic expectations and is also being open and honest about all of the options."

When it comes to spine problems, Dr. Murray says there’s not always a perfect option. However, "If you work with a good physician, you'll find the one that gets you the best possible results while avoiding unnecessary risks."

Making a decision about your spinal treatment plan

Being told you need any kind of medical treatment, including surgery, can feel scary. And while your care team is an excellent resource, the decision is ultimately up to you. "The patient is the only one who really knows what might fit them the best, and they're the only ones who live with the outcome," says Dr. Murray.

Getting a second opinion can help you stay better informed about your options and carefully consider your personal goals. What’s more, it allows you the time to weigh all the benefits and risks of each approach. This helps you feel confident in the decision and sets you up for a healthy future.

Next steps:

Make an appointment with spine care specialist
Read more about spine care at Main Line Health online
Who benefits from spine surgery?

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