When to Seek a Second Opinion for Spine Surgery

Patients can and should consult more than one physician for treatment advice. An orthopedic spine surgeon explains why.

When a surgeon recommends spine surgery, patients may wonder, “Should I get a second opinion?” 

Yes, you should if you have concerns about the necessity for surgery or the recommended surgical procedure, says Ram Kiran Alluri, MD, a spine surgeon with the USC Spine Center and USC Orthopaedic Surgery, part of Keck Medicine of USC.  

Dr. Alluri encourages his own patients to seek second opinions if they have any concerns regarding surgery. And when other patients come to him for a second opinion, he tells them they are doing the right thing by seeking multiple opinions. 

One advantage of the USC Spine Center, Dr. Alluri says, is that it is multidisciplinary, meaning that both orthopedic surgeons and neurosurgeons regularly collaborate to diagnose and develop an optimal treatment plan for a patient. 

“I can discuss a spine surgery with colleagues and get not only a second opinion but also a third, fourth and fifth opinion for a truly comprehensive assessment of a patient’s case,” Dr. Alluri says. 

A second opinion is especially useful when your first surgeon provides more than one treatment option, he notes. Even if several spine surgeons all agree on the cause of a problem, they may provide various treatment scenarios, each of them appropriate and valid for you to consider. 

What should I consider when making a treatment decision? 

Dr. Alluri recognizes that deciding which treatment route to take is not easy. “As surgeons, we provide patients with the surgical options and educate them on the risks and benefits, but ultimately patients have to make the tough decision,” he says. 

One important factor in making your decision is your comfort level with a surgeon. “If you do not feel comfortable, that is an easy decision — definitely look elsewhere,” Dr. Alluri says. 

While the patient-surgeon relationship is critical, also consider the entire surgical team and the facility. Ask yourself: “Is the office staff responsive? Are the other providers attentive? Does the hospital have an excellent reputation?” 

The entire care team makes a difference in your overall experience. 

“The most consistent feedback I get is that patients are not only pleased with the outcome of surgery but also by the care they received from all members of the team,” Dr. Alluri says. 

What should I ask my spine surgeon when considering surgery? 

The most important thing for patients to understand before spine surgery is its goal, Dr. Alluri says. Without that understanding, patients are more likely to be dissatisfied with the results. 

For example, if a patient with back pain has shooting pain down their leg, they should be aware that the primary objective of surgery is likely to improve or resolve the leg pain first, not the back pain. 

That also speaks to a general reality of spine surgery that patients should know: “There are so many potential pain generators in the lower back, including joints, discs and nerves, that all pain generators may not be addressed by a single surgery,” Dr. Alluri says.  

In addition to the goals of surgery, ask about the procedure’s risks, which can vary with the complexity of the condition and treatment. 

What should I ask after surgery? 

At the first postoperative visit, ask your surgeon how you are doing compared to the average patient. Not only will you learn whether you are recovering as expected, but you and your surgeon can catch potential issues early, when it is easier to intervene. 

In addition, ask about any postoperative restrictions you should follow to help avoid unnecessary complications. 

And if you feel worse after surgery, be transparent about it with your doctor. “Do not try to mask your symptoms,” Dr. Alluri advises. 

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Novid Parsi

Novid Parsi is a freelance writer for Keck Medicine of USC.

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