I just got home from my 2nd opinion consult. It was with the other neurosurgeon in my area considered to be an 'expert' in operating on spinal deformities.
This doctor has given me the opposite advice of the 1st surgeon. The 1st surgeon stated he definitely recommended surgery so up until yesterday I was scared but confident I was making the right decision. Now I am totally confused, discouraged and unsure. I do think it's the right decision to get a 2nd opinion but I'll admit getting two opposing recommendations really sucks.
Here's a comparison between the 2 consults:
1st Neurosurgeon -
Background: Completed his spinal surgery fellowship in 2007. Member of the SRS (Scoliosis Research Society). Started the ‘complex spine team’ at his hospital (which means 1. He always teams up with a 2nd neurosurgeon to do the fusion surgeries, 2. There is a monthly case review with a group of MDs [neurologists, internists, psychiatrists, etc.] from the hospital and as a team they decide yes or no on surgery, 3. They offer education classes to pre-op patients.)
My Consult: There was not much of a physical examination, he mostly studied my x-rays. He stated I have "very classic" Scheuermann’s Kyphosis with an 80 degree Cobb Angle (I believe from T3-L2) and recommended posterior fusion surgery T4 – L2. He said normal kyphosis is 20 - 45 degrees. He said if I don’t have surgery I risk losing bone density when I go through menopause and risk increased curvature and pain while being less fit for surgery due to the bone density loss. He states the pros of surgery outweigh the cons.
2nd Neurosurgeon -
Background: Completed his spinal surgery fellowship in 1991. Not a member of the SRS, though he has spoken at their conferences apparently. Has written two books on the spine, and served on the FDA panel for spinal devices.
My Consult: There was an extensive physical examination (bending, balancing, walking, etc.) and he studied my x-rays along with another physician who’s completing his fellowship. He stated I do NOT have Scheuermann’s Kyphosis but I have Idiopathic Hyperkyphosis with a 66 degree Cobb angle when measured from T5-T12 (which he says is the standard for measuring kyphosis). He said normal kyphosis is 30-60 degrees for my age group. He states I do not need surgery and he does not recommend it. He says if I take care of myself, menopause should not have too much of an impact on my spine. He feels the cons of surgery far outweigh the pros.
Right now at this second if I would say I cannot go through with surgery because the 2nd surgeon has much more experience than the 1st (plus the 1st surgeon is currently writing on research paper on the surgery so it makes me wonder if that somehow biases his recommendation). But I didn't realize how much I wanted the surgery until I was told no. Plus the first surgeon had really convinced me surgery was my best option for the future. So, I'm planning on driving down to Portland to see a 3rd specialist for a third opinion. I will have to pay for this one out of pocket (my insurance won't cover it) but I need a 'tie breaker' to be able to make the best informed decision.
Shouldn't I be relieved that the 2nd surgeon doesn't recommend surgery? I am terrified of the surgery. Does the fact that I'm so disappointed now mean that I wanted the surgery for the wrong reasons? I am super confused about this whole thing. Plus, I totally don't understand this variety in Cobb angles. I've been told 86 degrees (which I think is too high because I remember slouching for that one), 77 degrees, 80 degrees and now 66 degrees. What the heck!?!? I know every physician will get a slightly different Cobb angle from the same spine but this much? It seems ridiculous.
Thanks for letting me rant. I don't like to be so negative but I am just very discouraged right now.
Here's hoping I can get into the 3rd consult asap...