If you've been told your condition warrants spinal fusion and you are facing the prospect of surgery, it's time to ask yourself whether you should seek a second opinion. The notion of surgery can be intimidating; you don't want to proceed without knowing you've explored all therapeutic options.
Today we'll discuss when you should seek a second opinion about spinal fusion surgery.
But first, let's discuss spinal fusion itself. It is important to understand the procedure before you agree to surgery. By educating yourself, you will not only enter surgery with a greater understanding, but will also have a clearer idea concerning expectations, recovery, and a return to normal activities.
Spinal Fusion: A Brief Overview
The exact fusion procedure will not only depend on the extent of damage to your spine, but where the damage occurs and the underlying cause. Vertebrae are divided into five groups: cervical (seven neck vertebrae), thoracic (twelve chest), lumbar (five lower back), sacral (five fused), and the coccyx (four fused; these make up the tailbone).
Spinal fusion is undertaken for several reasons:
- Degenerative disc disease: when a vertebral disc breaks down over time or is damaged, the adjoining vertebrae may be fused to provide greater stability to the joint.
- Spondylolisthesis: one vertebra slips forward, causing radiating pain in the back and legs.
- Other conditions that produce instability within the vertebral joints, such as traumatic injury or osteoporosis.
During the fusion procedure, the disc may be removed, if necessary, and the adjoining vertebrae are then fixed in place using metal hardware (plates and screws) and a bone graft, which will eventually grow to fixate the joint. The graft may be taken from the patient (autograft) or from a cadaver donor, or a commercial bone replacement product may be used, such as bone morphogenic protein (BMP). The main downside of spinal fusion is the resultant fixation of the joint, which limits movement and flexibility of the area.
Should You Seek a Second Opinion?
There are times when it is appropriate to seek a second opinion concerning spinal fusion surgery. In general, this is when:
- Your surgeon does not communicate well. You need a physician who will offer thoughtful consultation, not only to instill confidence in their abilities, but to put you at ease and inform you about your surgery.
- Your surgeon only offers one option. If your surgeon can only offer a single option to correct your condition, it is time to consult with someone who can perform a range of procedures, so you know you are not limited by the surgeon’s lack of expertise.
- Your doctor has yet to try non-surgical options. If your physician recommends surgery without trying non-surgical therapies to correct your disorder, then you should seek a second opinion. There are many non-surgical treatments that can reduce pain, improve flexibility, and allow the body to heal naturally, so be sure you've explored all options before deciding on surgery.
- Your surgeon does not specialize in the procedure. You want a surgeon who has the necessary education, training, and experience in spinal fusion, so be sure your doctor is board certified in spinal surgery.
- Your surgeon does not offer minimally invasive procedures. If your surgeon does not perform the procedure using a minimally invasive route, it's time to seek a second opinion. Minimally invasive spinal surgery (MISS) offers many advantages over conventional spinal surgery. MISS is performed via high-powered microscopes through small incisions, which means less trauma to surrounding tissues, less blood loss, faster healing and recovery, and a quicker return to normal activity. Be sure your surgeon is experienced in MISS, so you receive the most up-to-date surgical procedure available.
Spinal fusion surgery should not be undertaken lightly. Explore all your options and be sure your surgeon has the necessary expertise to perform your procedure. Seek a second opinion if your situation calls for it, to ensure a confident, competent plan of action for your surgery.
About the author
Richard Kim, M.D. Born and raised in Southern California, Dr. Richard Kim earned his undergraduate degree in biochemistry from University of California, Riverside. This followed with a Master of Science in biochemistry and neurophysiology. He then earned his medical degree from St. Louis University School of Medicine in Missouri, graduating Magna Cum Laude. Read more articles by Richard Kim, M.D..