Fusion or replacement: what a second opinion should ask

Most people who walk into a spine surgeon's office with neck pain hear the same word within ten minutes. Fusion.

It is not a bad operation. For the right neck it is the right answer, and Dr. K says so when it is. But it is offered far more often than it is needed, and almost nobody is told what it costs them.

A fusion takes the worn disc out and locks the two bones together. The pain usually goes. So does the motion at that level, permanently, and the levels above and below take the load that one used to carry.

There is another operation. It takes the same disc out and puts an artificial one in. The nerve is freed the same way. The difference is that the level keeps moving.

So when you sit down for a second opinion, ask three things. Did you consider disc replacement for me, and if not, why not. What happens to the levels above and below this one in ten years. And how many of these have you done.

The answers will tell you most of what you need to know.