Check out this link to a fascinating, but concerning, article published by CBS News highlighting the significant variation that exists in the rates with which spinal fusion is offered to patients across the country.
In this article, CBS News publishes an online database revealing the number of spine fusions each doctor in the U.S. billed Medicare over a two year period. The data shows that some spine surgeons perform fusion procedures far more frequently than their peers emphasizing the need to obtain a second opinion if you are offered this type of surgery.
From 2001 to 2011, the number of spinal fusions in U.S. hospitals increased 70 percent, making them more frequently performed than even hip replacements.
Use this link to search your surgeon’s percentage of patients seen who received a spinal fusion, along with an explanation of how this data is to be interpreted.
Many people don’t know how to go about asking for, or getting, a second opinion on their spinal surgery–or, for that matter, many other important medical procedures.
If you find yourself in this group, don’t worry. We’re here to help! One of the questions we hear most frequently is…
Is it rude to ask for a second opinion on spinal surgery?
Absolutely not! Your good health and well-being are incredibly important and there is nothing wrong with asking for a second opinion.
Think about other big decisions in your life. Before buying a home, you speak to a number of trained professionals who help you understand which options are the best for you. Similarly, if your car needs work, you seek out more than one quote–not just to get the best price, but also to get peace of mind that both mechanics are identifying the same issue and recommending similar repairs. You should give your body the same consideration.
Of course, it’s polite of you to consider your doctor’s feelings, but rest assured: they will not be offended. Far from it! Your doctor is a professional. As such, he or she has your best interest at heart, will welcome anything that puts your mind at ease, and will appreciate the insights provided by a reputable spinal surgery second opinion.
And, remember: your spinal surgery is up to you. Your doctor should help guide you to the right choice for your situation, but the final decision is yours. As such, you should do everything in your power to make the choice clearer and to give yourself peace of mind.
How do I tell my doctor I want a second opinion
(or that I’ve already gotten one)?
Be forthright. You have a right to be involved in the process–it’s your spinal health that’s at stake!
Explain to your doctor that you want more information and would welcome a second opinion to ensure all options have been explored and that the best possible treatment path for your spinal surgery is chosen.
If your doctor appears angry or upset at your request for a second opinion, you should seriously consider looking elsewhere for your spinal care needs. Even if you remain with your doctor, keep in mind that you don’t need to rely on them for a referral. You can find expertly trained spinal surgeons online who will be happy to give you a reliable second opinion at a reasonable cost.
Remember, you get second opinions for all types of situations in your day to day life–don’t feel bad about asking for one when it comes to something as serious as spinal surgery.
Although second opinions are a very wise idea in spinal surgery, one instance when a second opinion does not make sense is in the case of a true surgical emergency known as cauda equina syndrome.
Although rare, very large herniated discs can cause this syndrome which is a combination of loss of bowel/bladder function, saddle anesthesia, and usually pain/weakness in the lower extremities.
Patients with a true cauda equina syndrome typically need urgent surgery to help reduce the risks for long-term problems, such as bowel, bladder, and/or sexual dysfunction, and/or paralysis
This article on Spine Universe effectively describes this condition in greater detail.
Cervical spondylotic myelopathy (CSM) is one of the more common reasons patients need to undergo surgery for their cervical spine. In this instance it’s not usually a question of whether or not you need surgery, but rather what’s the best surgery for you. Here second opinions can be invaluable.
Though precise figures are hard to come by, Dr. Ghogawala estimates the number of CSM surgeries has nearly doubled over the past decade or so to 200,000 a year, with some $4 billion a year in hospital charges alone.
Check out this brand-new article in the Wall Street Journal describing the current debate in spine surgery as to what will be the optimal surgical outcome for each individual patient with CSM.
Although spinal fusion surgery often immensely improves a patient’s quality of life, it’s also a big surgery with a long recovery and should be undertaken only after less intense options have been exhausted. For example, the same benefit can sometimes be achieved with a decompression procedure without the need to fuse.
Unfortunately, some surgeons are driven by financial incentives offered with the fusion procedure, causing them to recommend it more frequently than it’s truly needed. By getting a second opinion before your spinal fusion, you’ll ensure you don’t undergo surgery you don’t truly need.
“Physicians already have an incentive to do surgery — Medicare and insurers pay them for each surgery they do,” he said. “We trust doctors to use their judgment. The question is: Does this particular type of business heighten the incentive to move an otherwise honest doctor in the direction of unnecessary surgery? The report suggests that it doesn’t.”
Take the time and read this article posted last week in The Washington Post. Let us know your thoughts…
Check out today’s Wall Street Journal article on the frequency, harm, and cost of medical misdiagnosis. Diagnostic problems are more common than other medical mistakes, and adversely affect 160,000 patients each year. Diagnostic dilemmas in the evaluation, diagnosis and treatment of spinal disorders, in particular, are very common, underscoring the need to obtain a second opinion to verify the diagnosis and treatment plan before you undergo spine surgery.
Some researchers suggest the best solution isn’t to flood doctors with information but to provide a second set of eyes to find things they may have missed.
To read the full article click here
This article from the Washington Post points out that unfortunately many spine procedures including fusions are being done unnecessarily. Now more than ever, second opinions can prove to be invaluable. Check out this article and share your thoughts with us.
More than 465,000 spinal fusions were performed in the United States in 2011, according to government data, and some experts say that a portion of them — perhaps as many as half — were performed without good reason.
Laser spine surgery can seem like a quick and easy fix. Studies show the benefits are small and short lived. A second opinion is highly recommended.
Too often, we get asked by our patients about laser spine surgery and whether or not these institutes really offer benefit. Read this article and decide for yourself.
“Even in studies showing some benefit, the benefit is small and doesn’t last that long,” Chou said. Nerve endings can regenerate over time. It’s difficult to find a clinical basis for Laser Spine’s procedures, he said. “It sounds like a shotgun approach.”
To read the entire article by David Armstrong click here
Although laser spine surgery has received lots of press over the past few years, we at SOS believe that it can often do more harm than good.
Spinal surgeon Mark McLaughlin at Princeton Brain and Spine Care shares this view and explores in greater detail in this very insightful article. Here’s a short excerpt. Read the full article to hear more on why this specialist questions this practice:
“Do you use a laser in your spinal surgeries?”
That question makes the hair stand up on the back of my neck. I reply calmly and with authority, “No.” I continue, “I am trained in laser surgery. It has almost zero usefulness in your spine surgery and in fact may be harmful.”
Read the full article here: The Myth in Laser Spine Surgery.
If your surgeon has recommended laser surgery for your spinal condition, we strongly recommend you seek out a second opinion.
Having performed spinal surgery for a cumulative 30 years, my partner Dr. David Kramer and I regularly encounter patients who have received recommendations for surgery from other doctors that simply don’t address their needs. Why undergo surgery unless it’s absolutely necessary? In cases such as these, we explain to the patient what their non-surgical options are and encourage them to pursue these solutions rather than undergoing the knife.
As we’ve reviewed more and more cases like these, it has underscored a truth we’ve always known: second opinions are invaluable and can help save people from costly and invasive surgery.
Unfortunately, too many people simply don’t get spinal surgery second opinions, either because they are unaware of the value or because of the potentially prohibitive cost (particularly if your health insurance doesn’t cover the expense!).
To help address his need, we created Second Opinion Spine. Now, you can get trustworthy second opinions easily and economically.
Here’s how it works:
- Submit your contact information here.
- A member of our staff will contact you for more information about your spinal condition.
- One of our expertly trained surgeons (David or I) will review your case and contact you personally to give you a second opinion and discuss your options.
It’s just that simple.
If you are in need of a second opinion, please don’t hesitate to contact us. We are here to help!