Most people who have problems with their backs or necks trust their doctors to give them knowledgeable, responsible advice about how to get better.
The vast majority of doctors deserve that trust. However, there have been numerous occasions where a patient will see me in the office and tell me that another doctor has recommended surgery. To be honest, I’m sometimes shocked at some of the explanations why surgery is recommended over conservative treatment. The reason is that some of it just ain’t so. Here are some of the phrases which, if you hear them, would justify a second opinion:
- “If you don’t have the surgery, you may end up in a wheelchair later.” – The vast majority of spine problems tend to get better, not worse, over time. Even when conditions don’t improve, they almost never become so bad that a patient would end up in a wheelchair. Sometimes surgery may be a good solution to a problem that won’t go away. However, in almost all cases a patient can take his or her good sweet time deciding on it. Having the surgery later rather than earlier almost never compromises the final result. There are some unusual cases where surgery really must be done quickly: tumors or infections of the spine, spinal cord squeezing in the neck or nerve pressure that is creating progressive weakness. But for the most part, if you hear “surgery” and “wheelchair” together in the same sentence, get a second opinion.
- “You need surgery” – This is basically a short and sweet variation of the “wheelchair” threat. Almost nobody needs spine surgery. Sometimes it is the best option to achieve a good result and alleviate pain, but the final decision should always be the patient’s. Except for the cases above, spine surgery is not “needed” like heart surgery or other life saving surgery. Spine surgery is for the most part elective surgery to help relieve pain. If you are told you need spine surgery, get a second opinion.
- “You’ll be back to 100% in no time” – There is no operation that has a 100% success rate. Even world famous surgeons have their failures. Pain relief is rarely absolutely complete after a spine operation. When you are considering surgery, find out about the expected benefits of the operation, balance it against the risks involved, and weigh it against the non-surgical alternatives. Ask about the chances of success. If you are quoted 100%, get a second opinion.