When should you get a second opinion on back surgery?

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Like most people, you may have experienced back pain at some point in your life. The pain can range from an occasional twinge from sleeping awkwardly to a stinging, stabbing pain that affects everyday life.

Caused by strain, injury or overuse, most back pain isn’t serious. But when it persists or becomes debilitating, it’s time to see your doctor.

Back pain often is manageable with a treatment plan of exercises, pain medication and rest. Occasionally, a more serious condition is detected, and back or spine surgery may be your doctor’s recommendation. Should you follow that recommendation?

No one would choose to undergo surgery unless it’s absolutely necessary and the potential benefits outweigh the risks, according to Harvinder Deogun, MD, a specialist in physical medicine and rehabilitation at HonorHealth Spine Group Arizona, and Luis M. Tumialan, MD, director of minimally invasive spinal surgery at HonorHealth Spine Group Arizona.

You don’t want to second-guess your physician, but there’s nothing wrong with knowing all of your options and being an informed, educated patient.

Doctors Deogun and Tumialan weigh in on when it’s time to get a second opinion.

When should you get a second opinion on back surgery?

Is it common to get a second opinion?

Dr. Deogun: It’s almost always a good idea to get a second opinion because spine surgery is such a serious issue that can have long-lasting effects on you, whether good or bad. So just like you get second opinions on things like home improvements, it makes sense to get second opinions on spine surgery as well.

Dr. Tumialan: Let me answer this question by providing my mother as an example. When she had a shoulder issue, and the possibility of a shoulder replacement was brought up, I did not have her get two opinions, I had her get three. That may have been overkill, but all surgeons independently came up with the same answer. My father, my sisters, and most importantly, my mother, were all reassured by that process.

All patients have a moment of clarity as to when to go to surgery; that moment comes at different times for different patients. Sometimes an additional opinion helps with reaching that peace of mind.

I’ve already had a spine procedure, and my doctor is recommending I have another more extensive surgery. Should I go through with it?

Dr. Tumialan: A second spine procedure is a difficult pill to swallow. The initial operation was undoubtedly a psychological, physical, emotional and even financial stressor. Finding out that additional surgery is needed can be demoralizing. It wouldn’t be responsible to offer a blanket answer to the question of whether or not to proceed.

It should be known that any surgery that offers patients the potential benefit of decreased pain and improved quality of life comes at the risk of potentially needing additional surgery. It’s important to understand the objectives of the operation and fully understand the additional risk.

When should I get a second opinion?

Dr. Tumialan: This question is better answered by asking: “When should I not get a second opinion?” You should not get a second opinion when you have a neurological deficit or rapidly declining neurological function and you’ve found a surgeon willing to help you in a timely fashion. Obtaining a second opinion may take weeks. It may delay the eventual intervention, which may offer a better outcome had it been timely.

I see that online second opinions are available. What are the benefits/drawbacks to receiving advice this way?

Dr. Deogun: Benefits to an online second opinion include convenience. However, you cannot truly get a comprehensive evaluation and have a chance to get all of your questions answered without an in-person appointment with a surgeon. I would always recommend a second opinion in person with a spine surgeon.

Dr. Tumialan: Second opinions online can be beneficial if you’re hearing the same thing from another surgeon. That would indicate you have a relatively straightforward problem that consistently has a uniform solution. That automatically places you in a good category.

The potential drawback is when you hear a different solution to the problem. Fortunately, by the time you obtain a second opinion you’re better prepared to ask questions and will be able to have a greater understanding of your options.