Why You Need a Second Opinion Before Spinal Surgery

I worked 18 years in an orthopedic clinic and 5 years in a neurosurgical clinic. The neurosurgeon would always encourage his patients to get a second surgical opinion. Why? Because opinions differ among surgeons, and he was confident in his opinion. During the 5 years I spent with him, I learned, and this is not widely-known, that surgery is sometimes a grey area. And you go to a doctor to think about these grey areas and make judgements about the best course in the real, messy world.

For example, we would often see a patient with 4 to 8 problems in their low back, of varying severity. As a surgeon, you have to correlate the patient’s signs and symptoms, and exam findings, with the diagnostic imaging. Then you have to use your judgement to decide which of all the problems that you see, do you have to address, surgically, in order to get the patient better enough, with the least risk necessary.

In other words, how ambitious should you be with surgery? And you have to take non-medical issues into account- what we call the biopsychosocial model. So you have to decide, “do you know what has to be done, with what certainty, and do you have the technical skills to do it”? Surgery is good when it is the “right” surgery at the right time, for the right problem, in the right patient, by the right Chiropractor Doctor in Decatur GA. That is a complicated calculus.

Some surgeries, however, are much simpler to determine and treat. But surgeons can differ about these too.

The surgeon I worked with would also framed his opinions in an interesting way to patients, which might surprise patients and doctors who don’t do surgery. Since most surgeries are NOT mandatory, they are elective, and done for pain, which is a very subjective experience, he would tell patients that he was willing to “offer” them surgery, if they wanted it. And he would only offer them surgery when it met the criteria above, all “right”.

He would say that he sees a problem, that he thinks explains most of their pain, and that he was willing to perform a particular surgical procedure, and it was not likely to resolve all of their pain, but it should improve them significantly. He would try to underpromise, and over-deliver, if that is possible.

All of the above is in the context of a good, ethical, conservative surgeon. Some surgeons, however, may not be good at certain procedures, or they may be too aggressive in recommending surgery. Unfortunately, I have seen surgeons, even from prestigious medical schools, be too aggressive in their surgical recommendations.

Can a non-surgeon opine on surgery? Sometimes, yes. Having worked and known good surgeons, and procedures, and knowing a reasonable treatment algorithm, I can opine on surgery, and send patients to other surgeons for their surgical opinions. 

I have known many non-surgeons who know so little of surgery that they have just decided to discourage surgery in all cases. Unfortunately, when it comes to surgery, the devil is in the details, and condemning surgery is not really in the interest of all patients. I have sent many patients for surgery who did not want it, but they also didn’t understand what was their problem, and the likelihood of improvement from surgery. They also trusted me because I explained things thoroughly and I had no financial gain in recommending surgery.

Generally, you should get at least two surgical opinions. And you might happen on a non-surgical provider who knows about surgery, or, at least, thinks s/he knows a good surgeon to see.

Here is another surprise for many patients. Just because you have pain, and no non-surgical provider has been able to help you, does not mean you have a problem that will improve from surgery. Sometimes a surgeon will tell you that s/he does not recommend surgery, even though nothing else has helped you. Surgery is not an experiment to do, to see if it will help because nothing else has. There are occasional exceptions to this. But, mostly, the surgeon has to see something on imaging that he is reasonably certain can be treated, and would improve your pain. S/he doesn’t want to do sugery that doesn’t help.

So if you want a second surgical opinion from a non-surgeon, I am happy to evaluate your problem, history, and imaging to see if I can help you, or refer you to an excellent surgeon for a second opinion. There are many excellent surgeons in Atlanta for spinal surgery. 

So if you are searching for a surgery spine second opinion Decatur, or chiropractor decatur ga, please call me at 404-558-4015. You can come here to Backstrong Non-Surgical Rehab Clinic in case of Emergency.

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