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Old 11-13-2012, 10:14 AM   #1
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Two surgeons, different surgical opinions. help!

Okay here is the long and short of it.

I need a ACDF of my C7-T1, on that all the surgeons agree. I had a ACDF of C4- C7 back in 2008 and did just fine. fused well.

1. Original surgeons plan. One day stay in the hospital. Take my hardware from C4-C7 out. Fuse C7- T1. Hard collar for 4 weeks, soft collar for 2 weeks. I would be out of work for up to 8 weeks.

2. Second opinion. One day stay in the hospital. He would leave my existing hard ware from my first fusion alone. ( if it ain't broken don't touch it) he would just fuse C7-T1. No collar or perhaps a soft collar. Out of work 2-4 weeks.
I had a third opinion that was similar to second opinion.

I just don't know what to think. I understand that every surgeon has a different way of going about things. Some are old school and some practice new methods. I just don't know what to do about the hardware and the hard collar or no collar options. It's very different. Please weigh in on this if you have ever had the issue of dueling opinions. What did you end up doing?

I need to make a decision soon. I'm in pain and want to get this over with. But I want to make sure I have thought this out.
Thank you!
Elayne

Last edited by elayne1129; 11-13-2012 at 11:43 AM. Reason: Forgot about third opinion

 
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Old 11-13-2012, 10:44 AM   #2
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Re: Two surgeons, different surgical opinions. help!

Quote:
Originally Posted by elayne1129 View Post
Okay here is the long and short of it.
I need a ACDF of my C7-T1, on that all the surgeons agree. I had a ACDF of C4- C7 back in 2008 and did just fine. fused well.
1. Original surgeons plan. One day stay in the hospital. Take my hardware from C4-C7 out. Fuse C7- T1. Hard collar for 4 weeks, soft collar for 2 weeks. I would be out of work for up to 8 weeks.
2. Second opinion. One day stay in the hospital. He would leave my existing hard ware from my first fusion alone. ( if it ain't broken don't touch it) he would just fuse C7-T1. No collar or perhaps a soft collar. Out of work 2-4 weeks
I just don't know what to think. I understand that every surgeon has a different way of going about things. Some are old school and some practice new methods. I just don't know what to do about the hardware and the hard collar or no collar options. It's very different. Please weigh in on this if you have ever had the issue of dueling opinions. What did you end up doing?
I need to make a decision soon. I'm in pain and want to get this over with. But I want to make sure I have thought this out.
Thank you!
Elayne


Hi elayne, I have old hardware(plate & screws) in my wrist from internal fx repair. Left it in since 2000. I fell the other night & was falling in the street. I stopped myself with this wrist! Scared to put it down to stop myself, yes. But better than squashed skull! It held! I'm a back patient ,too. But, not cervical. There are many people that have had your surgery & revisions here. They will be glad to help. Meanwhile, you can put name of surgery or key words in the "search"section @ the top of each board and read current & closed threads about what others did. Look in this board & try back problems. Thats where I see most posts about cervical fusions. Personally, Im glad that hardware was there! But, you wont fall on your neck! Lol

 
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Old 11-13-2012, 11:30 AM   #3
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Re: Two surgeons, different surgical opinions. help!

Thanks. I did do some searching but can't seem to find what I am looking for. I find a lot of post regarding hardware removal for issue witht the hardware it's self or issues with non union. I have neither issue. My fusion is fine and hardware is stable.

I'm just not sure what route to go.

 
Old 11-13-2012, 11:36 AM   #4
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Re: Two surgeons, different surgical opinions. help!

Quote:
Originally Posted by elayne1129 View Post
Thanks. I did do some searching but can't seem to find what I am looking for. I find a lot of post regarding hardware removal for issue witht the hardware it's self or issues with non union. I have neither issue. My fusion is fine and hardware is stable.

I'm just not sure what route to go.
Get a third opinion!


MTA: I'm going for my first fusion (2 level) and will have a soft collar but only to remind me that I just had surgery. Both surgeons I saw were pretty much on the same wave length when it came to my surgery. Not that I have any experience of having previous surgery I think the 2nd surgeons way is sound

Last edited by rockenmama; 11-13-2012 at 11:39 AM.

 
Old 11-13-2012, 11:41 AM   #5
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Re: Two surgeons, different surgical opinions. help!

Sorry forgot to put in my post that I had third opinion, he was identical to second opinion.

 
Old 11-13-2012, 11:43 AM   #6
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Re: Two surgeons, different surgical opinions. help!

Quote:
Originally Posted by elayne1129 View Post
Sorry forgot to put in my post that I had third opinion, he was identical to second opinion.
Well if you had 2 opinions going with number 2...... IF it were me I'd go with number 2 however it is not for what that's worth

 
Old 11-13-2012, 11:49 AM   #7
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Re: Two surgeons, different surgical opinions. help!

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Originally Posted by rockenmama View Post
Get a third opinion!


MTA: I'm going for my first fusion (2 level) and will have a soft collar but only to remind me that I just had surgery. Both surgeons I saw were pretty much on the same wave length when it came to my surgery. Not that I have any experience of having previous surgery I think the 2nd surgeons way is sound
Yeah I guess I am just floored at how conservative my original surgeon is verses the two other opinions that I got. But this is what happens when you are in a situation like mine. The first time around I didn't have the luxury of getting another opinion of the surgical approach. Now I have two identical opinions that differ from my original surgeons plan of how he would treat my issue and its making my head swim. Oh what to do, what to do....

 
Old 11-13-2012, 03:53 PM   #8
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Re: Two surgeons, different surgical opinions. help!

Dear elayne, put in search the initials for your surgery then need revision or name of surgery you had & have to have surgery again. Or cervical**** dr wants. Or put had**** onC0-C0 now wants to do C1-C1 for example.

Last edited by gmak; 11-13-2012 at 04:02 PM. Reason: add info

 
Old 11-13-2012, 06:14 PM   #9
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Re: Two surgeons, different surgical opinions. help!

Yeah I'm searching like crazy to find someone in a similar situation. It's tough because my original surgeon is painting me the picture of a much more invasive surgery and I just can't see the purpose of removing hardware that is in good shape and is causing me no issue. The other two surgeons are leaving things alone and just doing the one level. I have a lot to think about and not much time to do it in.

 
Old 11-14-2012, 04:03 AM   #10
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Re: Two surgeons, different surgical opinions. help!

Quote:
Originally Posted by elayne1129 View Post
Yeah I'm searching like crazy to find someone in a similar situation. It's tough because my original surgeon is painting me the picture of a much more invasive surgery and I just can't see the purpose of removing hardware that is in good shape and is causing me no issue. The other two surgeons are leaving things alone and just doing the one level. I have a lot to think about and not much time to do it in.
Good morning elayne, i have had 4 back surgeries. My believe system about all back surgery is the less done the better! However, your original surgeon is the one that performed 1st surgery, its great, so you trust him. If you can, courage wise( i know that this will be hard) go back to old dr, and ask what is the advantage of taking out old hardware. And, why would he want to disturb whats firmly sound. If you have to, tell him of other opinions. Only, if you have to. Because I know that its probably easier for you to undergo surgery with him as surgeon. To me, leaving well enough alone & getting fusion just @ C7-T1 makes sense, less recovery etc. But, who knows maybe he knows something we dont,i.e. hardware showing wear & tear etc. Find out why. Thank you, gmak

 
Old 11-14-2012, 06:53 AM   #11
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Re: Two surgeons, different surgical opinions. help!

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Originally Posted by gmak View Post
Good morning elayne, i have had 4 back surgeries. My believe system about all back surgery is the less done the better! However, your original surgeon is the one that performed 1st surgery, its great, so you trust him. If you can, courage wise( i know that this will be hard) go back to old dr, and ask what is the advantage of taking out old hardware. And, why would he want to disturb whats firmly sound. If you have to, tell him of other opinions. Only, if you have to. Because I know that its probably easier for you to undergo surgery with him as surgeon. To me, leaving well enough alone & getting fusion just @ C7-T1 makes sense, less recovery etc. But, who knows maybe he knows something we dont,i.e. hardware showing wear & tear etc. Find out why. Thank you, gmak
I think the only reason why the original surgeon would take out my existing hardware is because its in the way and he can't fuse the level beneath unless he takes it out. so its simply a space issue.
The other two surgeons that I consulted with would leave it in and I think use a different hardware that would not interfere with the existing hard ware above. It's hard to know what to do. I was up all night thinking about it. I still don't have a good sense or feel of which direction I want to go in. I wish my gut would tell me something. Right now I got nothing.

 
Old 11-14-2012, 07:06 AM   #12
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Re: Two surgeons, different surgical opinions. help!

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Originally Posted by gmak View Post
Good morning elayne, i have had 4 back surgeries. My believe system about all back surgery is the less done the better! However, your original surgeon is the one that performed 1st surgery, its great, so you trust him. If you can, courage wise( i know that this will be hard) go back to old dr, and ask what is the advantage of taking out old hardware. And, why would he want to disturb whats firmly sound. If you have to, tell him of other opinions. Only, if you have to. Because I know that its probably easier for you to undergo surgery with him as surgeon. To me, leaving well enough alone & getting fusion just @ C7-T1 makes sense, less recovery etc. But, who knows maybe he knows something we dont,i.e. hardware showing wear & tear etc. Find out why. Thank you, gmak
I think the only reason why the original surgeon would take out my existing hardware is because its in the way and he can't fuse the level beneath unless he takes it out. so its simply a space issue.
The other two surgeons that I consulted with would leave it in and I think use a different hardware that would not interfere with the existing hard ware above. It's hard to know what to do. I was up all night thinking about it. I still don't have a good sense or feel of which direction I want to go in. I wish my gut would tell me something. Right now I got nothing.

 
Old 11-14-2012, 09:07 AM   #13
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Re: Two surgeons, different surgical opinions. help!

Since you had three opinions and two said the same thing, I'd go with them. Like you said earlier, if it ain't broke, don't fix it! The hardware seems to be stable so I would just be leary of removing it. Or, I'd do what Gmak suggested and ask your original surgeon if he could do the surgery without the hardware removal. You already trust that surgeon. If you aren't comfortable with letting him know you received a second and third opinion, just tell him you had a friend who had the same scenario, but they had the hardware left in, and how would that work in your case. Maybe it will open his eyes to a different type of hardware for the c7-t1 so he'd have enough space??? I can definitely see the benefit of going with your original surgeon, but I would try to get him to leave the old hardware alone!
Good luck! And be sure to keep us posted as to what you decide to do!

 
Old 11-14-2012, 11:15 AM   #14
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Re: Two surgeons, different surgical opinions. help!

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Originally Posted by Whynowthis View Post
Since you had three opinions and two said the same thing, I'd go with them. Like you said earlier, if it ain't broke, don't fix it! The hardware seems to be stable so I would just be leary of removing it. Or, I'd do what Gmak suggested and ask your original surgeon if he could do the surgery without the hardware removal. You already trust that surgeon. If you aren't comfortable with letting him know you received a second and third opinion, just tell him you had a friend who had the same scenario, but they had the hardware left in, and how would that work in your case. Maybe it will open his eyes to a different type of hardware for the c7-t1 so he'd have enough space??? I can definitely see the benefit of going with your original surgeon, but I would try to get him to leave the old hardware alone!
Good luck! And be sure to keep us posted as to what you decide to do!
The original surgeon was pretty firm about his plan. And I suspect because of the type of hardware that he put in me last time it limits what he feels he can do for the level below. Plus if he is use to doing things a certain way and is use to a certain kind of "product/hardware" well... it comes down to surgeons preference i suppose. I also suspect that perhaps his methods are a bit old school, because the two other surgeons had no problem with leaving my existing fusion well enough alone and fusing one level below. And neither one would put me in a hard collar for weeks on end.
In the end I just want the best possible out come. And that is so hard to predict. Trying to figure this out is frustrating.

Last edited by elayne1129; 11-14-2012 at 11:17 AM.

 
Old 11-18-2012, 03:38 PM   #15
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Re: Two surgeons, different surgical opinions. help!

Quote:
Originally Posted by elayne1129 View Post
The original surgeon was pretty firm about his plan. And I suspect because of the type of hardware that he put in me last time it limits what he feels he can do for the level below. Plus if he is use to doing things a certain way and is use to a certain kind of "product/hardware" well... it comes down to surgeons preference i suppose. I also suspect that perhaps his methods are a bit old school, because the two other surgeons had no problem with leaving my existing fusion well enough alone and fusing one level below. And neither one would put me in a hard collar for weeks on end.
In the end I just want the best possible out come. And that is so hard to predict. Trying to figure this out is frustrating.
Hi elayne, i wanted to check on your decision. I just saw the last post,you know you wouldnt want your old surgeon using something he is not used to using. And, after thinking you have proven success with this dr. Fusions of all types have to take. This dr delivered that, and is he invested in you? Would you say that he cares about your success more than someone that never met you before? I saw 3 neurosurgeons this year. One old school who said no surgery would be successful on me, in fact it would harm me. The second were thirty something, faculty of major medical school,professors as well as neurosurgeons. #1. Minimally invasive neurosurgery of complex spinal trauma & spinal injuries- said i couldnt be touched but would send me to a pain mgmt neurosurgeon for a morphine pump. Thats touching me in the form of cutting into my spinal fluid a 1" incision #2 specialty in people that cant walk, pain mgmt, facial nerves probs, & general neurosurgery said couldnt touch me but wanted to do spinal cord stimulator, that's a 3" incision in the meninges where spinal nerves live.
Full blown back surgery. I wish all the people on healthboards knew that whether a
medtronic or st. Jude spinal cord stimulator or a morphine pump, that IS full blown back
surgery! Who would I trust? Who would you trust? #1 for me! Old school dr that showed
that he was invested in my well being. More than hotshots breezing in & if ruined my
already ruined life would walk away scot free. So, i just felt like I should tell you this story.
Please keep us posted on decision, progress or needing a shoulder of someone understanding. Thank you, gmak

Last edited by gmak; 11-18-2012 at 03:42 PM.

 
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