Getting a Second Opinion on Spine Surgery in San Antonio: What to Bring and What to Expect

A second opinion is a normal part of deciding on spine surgery. Good preparation makes it far more useful.

If you have been told you need spine surgery, getting a second opinion is a reasonable, common step, and surgeons expect it. Most spine surgery is elective, so there is usually time to be sure. The most useful second opinions happen when you bring your actual imaging and records, not just a summary. This guide covers when a second opinion is worth getting, what to bring, and what to expect at a visit with Dr. Adapa at the Huebner Clinic in the San Antonio Medical Center.

When a second opinion is worth getting

Any recommendation for spine surgery is a reasonable time to get a second opinion. It is especially worth considering when:

• A fusion has been recommended, particularly across several levels
• You are unsure the diagnosis explains your symptoms, or the explanation did not make sense to you
• You have not had a real trial of nonsurgical care, such as physical therapy or injections
• The operation is large or complex, such as deformity correction or revision surgery
• A previous spine operation did not help, or your symptoms have come back
• You have been told nothing more can be done, and you want to confirm that
• You felt rushed, or did not get to ask your questions

A second opinion does not mean you distrust your first surgeon. It means the decision matters enough to be sure.

When not to wait

If your first surgeon has told you that surgery is urgent, ask them to explain why. If the reason is spinal cord compression with worsening symptoms, a second opinion should happen quickly, within days rather than weeks. Call the office and say so.

What to bring

The quality of a second opinion depends on the information available. Bring as much of the following as you can:

Your actual imaging, not just the reports. This is the single most important item. A written radiology report summarizes the scan; Dr. Adapa needs to see the images himself. Ask the imaging center (not the surgeon's office) for your MRI, CT, and X-rays on a disc, or for a link to an online image portal.

Radiology reports for the same studies.

The first surgeon's notes, including the surgical recommendation and the reasoning behind it, if you have them.

Records of treatment you have already tried: physical therapy notes, injection records, and medications, including what helped and what did not.

Your operative report, if you have had spine surgery before. It describes exactly what was done and is essential for evaluating a previous operation.

A list of current medications and doses.

Your questions, written down. Write them out before you come, rather than trying to remember them in the room. Consider bringing a family member or friend to help remember the answers.

Getting your records

You have a legal right to copies of your own medical records and imaging. A few tips:

• Request imaging directly from the imaging center or hospital where it was done. It is usually faster than going through a doctor's office.
• Ask for images on a disc or through a portal, in addition to written reports.
• Allow a week or two, and request records as soon as you book the appointment.
• Other providers can also fax records to the office at 210-293-9381.

If you cannot get everything before the visit, come anyway. Dr. Adapa can often still help, and can arrange for missing images if needed.

Insurance and cost

The office can tell you whether your plan is accepted, including Medicare, Medicaid, workers' compensation, VA referrals, and self-pay. Have your insurance card with you and call 210-293-9380.

Two things are worth settling before you come:

• Whether your plan needs a referral. Some plans, particularly HMOs, require one before they will cover a consultation. Many do not. The office can check yours in a couple of minutes.
• How your plan treats a second surgical opinion. Some plans cover it specifically. Your insurer can confirm what applies to you.

What happens at the visit

A conversation first. Dr. Adapa will ask about your symptoms, what they stop you from doing, what treatment you have already had, and what you were told at your first consultation.

An examination. He checks strength, sensation, reflexes, coordination, and walking. The examination is what confirms whether the findings on your scan are the cause of your symptoms.

A review of your imaging, with the images on screen. You should see what he sees and understand how it relates to your symptoms.

An explanation and a recommendation. You will hear his view of the diagnosis and the reasonable options, starting with nonsurgical care where it may help.

Sometimes more information is needed first, such as standing X-rays, X-rays taken while bending, a CT scan, or nerve testing. If so, Dr. Adapa will explain why.

What the outcome might be

A second opinion can end in several ways:

• Agreement with the original recommendation. Many patients find this reassuring and proceed with more confidence.
• A different treatment, such as a further trial of nonsurgical care before surgery is reconsidered.
• A different operation, for example a smaller operation, or a motion-preserving alternative to a fusion where the anatomy allows it.
• A different diagnosis, occasionally, when the symptoms point to a source other than the one first identified.

Whatever the outcome, the choice of what to do next, and who does it, remains yours. Getting a second opinion from Dr. Adapa does not commit you to having surgery with him.

Planning your visit

Appointments can be requested online or by phone.

Dr. Adapa's approach

Second opinions are welcome, including when surgery has been recommended elsewhere and when a previous operation has not worked. Dr. Adapa's aim is to give you a clear explanation of what is causing your symptoms and an honest view of your options, so you can make a decision you are confident in, whoever ends up treating you.

Read next

• Revision spine surgery
• Patient resources: what to bring to your first visit
• Locations and directions