Second opinion
Been told you need surgery?
Before you schedule it, have the reasoning examined. A second opinion is welcome here for its own sake, including when it confirms what you were already told.
Spine surgery works well when it is aimed at a specific structure that explains your symptoms. It works poorly when it is aimed at a finding on a film that was always going to be there.
The difference between those two situations is not always obvious from inside the consultation where the recommendation was made. That is what a second opinion is for: not to disagree, but to check that the reasoning holds.
Who this is for
Five reasons people come.
- 01
You have been told you need a fusion
This is the most common reason people come for a second opinion, and it is a reasonable one. Most patients treated for stenosis need a decompression alone, and fusion is added when a specific finding calls for it. Whether yours is one of those cases is a question with a checkable answer.
- 02
You want to know whether a motion-preserving option exists
In the neck, disc replacement decompresses the nerve while keeping the segment moving, in patients whose facet joints and alignment support it. Whether you qualify is decided from your imaging, and it is not always raised before a fusion is proposed.
- 03
Symptoms have persisted despite treatment
Months of therapy or injections without improvement sometimes means the treatment was aimed at the wrong structure. Sacroiliac joint pain treated as sciatica is a common version of this.
- 04
You want your imaging read by another spine surgeon
Not the report, the films. A radiologist describes what is present. A surgeon looks at whether what is present explains your symptoms, which is a different question and the one that drives the decision.
- 05
Surgery has already been done and has not helped
Sometimes the original problem was correctly identified and something else has developed. Sometimes it was not. Either way it is worth working out which before considering another operation.
How it works
Four steps.
The aim is a clear answer about your own spine, in terms you can repeat back to someone else.
Send what you have
Imaging on a disc or a share link, any reports, and a brief account of what has happened so far. The office will tell you how to send records securely.
The films are reviewed directly
Dr. Sayari looks at the images himself rather than working from the radiologist's summary, and compares what they show against what you describe.
You get a straight answer
Whether the structure identified explains your symptoms, whether the proposed operation addresses it, and whether a smaller one would. Including, frequently, that no operation is needed yet.
You decide
A second opinion that confirms the original plan is a useful result. Going back to your first surgeon with more confidence is a perfectly good outcome, and it happens often.
What you will be asked
The questions that decide it.
These are the same questions worth putting to the surgeon who made the original recommendation, and they are what this consultation works through.
- Which specific structure is causing the symptoms, and how do we know
- Does the level on the imaging match the level on examination
- What exactly is the operation expected to improve, and what will it not improve
- What has been tried already, and was it aimed at the right structure
- Is there a smaller operation that would address this
- If a fusion is proposed, which finding makes it necessary rather than a decompression alone
- What happens if nothing is done for three months
A recommendation that survives those questions is one you can proceed with confidently. One that does not is worth another look.
Common questions about second opinions
- Will you just tell me I do not need surgery?
- No. A second opinion that always says the same thing is not an opinion. Sometimes the first recommendation is correct, sometimes a smaller operation would do, and sometimes the answer is that nothing should be operated on yet. The point is that the reasoning gets examined, not that it gets overturned.
- Is it awkward to get a second opinion?
- It should not be, and it is routine in spine surgery. A confident recommendation survives being examined by someone else. If a surgeon reacts badly to the idea, that has told you something worth knowing.
- Is a second opinion covered by insurance?
- Many plans cover second opinions, and some require one before authorising elective spine surgery. Coverage depends on your specific plan. Call the office with your insurer and plan name before the visit and you will get a straight answer.
- What should I bring?
- The actual imaging, on a disc or a share link, rather than only the written report. Any prior operative notes. A short list of what treatment you have already had and for how long. And the questions you have been carrying around, written down.
- Do I need to stop seeing my current surgeon?
- Not at all. A second opinion is information, not a transfer of care. Plenty of patients take the answer back to the surgeon who made the original recommendation and proceed there.
- How quickly can I be seen?
- That depends on the office and the week. If you have a surgery date already booked, say so when you make contact, because it changes how the appointment is scheduled.
Request
Send your imaging. Get a straight answer.
Tell us how to reach you and someone from the office will be in touch about the visit and about sending your records securely. If you already have a surgery date booked, say so and it will be taken into account.
Prefer to speak to someone? Call (312) 313-1086.
Where to be seen
Consultations for a second opinion are available at all eight Academy offices.
Not sure which is closest? See the areas we serve, or call (312) 313-1086.
Second opinions are reviewed by Arash J. Sayari, MD, a fellowship-trained, board-certified orthopaedic spine surgeon. A substantial part of his practice is second opinions.Credentials and training.