Second opinion for L3-4 spinal stenosis. Questions to ask?

I am so glad that I got/am getting a second opinion. The first neurosurgeon made a decision based only on an MRI. Doing a L3-4 laminectomy didn't match my symptoms. He'd done my first two surgeries. I trusted him. But when I got the second opinion from a different institution, that doctor ordered more testing-vascular, X-rays, EMG and a CT scan. He has found the primary problem. L5, not just L3-4. I'll meet with doctor #2 in a few weeks to make decisions about next steps.

Here great advice: Unless you are perfectly content with your diagnosis, always get a second opinion. Tell your doctor that getting a second opinion, but, rather a standard practice, you always do.

I have an odd spinal stenosis going side to side, L3-4. I've had a hemilaminectomy and TLIF of L4-5 several years ago. I've had 2 opinions, first from my original doc who initially said laminectomy but then 2 months later said he wanted to get a prone MRI first. (On my belly) the second opinion said 3 level fusion. My brother in CA insists I get a third opinion from his spine surgeon. (I'm in the Boston area.) That doc would look at all the images over the last 5 years and have a Zoom call with me, and it would cost $400. He'd only make recommendations and knows I wouldn't travel for surgery. I'd also need to register with the hospital, which costs $185. I'm on Medicare and so I pay nothing in MA for doc visits. I'm tempted to go to this doc's colleague here, Dr Eric Woodard at New England Baptist Hospital. Any thoughts or suggestions out there? Anyone have experience with Dr Woodard?

I would always go and get a 2nd opinion and a 3rd if need be. I rather be cautious. I would also look at some other non-surgical options that I have heard about.

I too have been told I need surgery for my L3-L5 curved spine. I have gotten 2 opinions and all were the same. Major surgery, fixing the disc that has deteriorated. But due to my other health conditions my doctors are reluctant to approve me for surgery.

@peter51f
What are the other non-surgical options you are referring to?
I think I'll wait until after I've had the prone MRI and I've seen the surgeon who do my two other back surgeries. There are only a limited number of different surgical approaches that can be done.
I spoke with a good friend who is a chiropractor and treated me for 20+ years so she knows me and knows my spine very well. She is unusual in that she is not anti-surgical intervention. Her feeling is I can go for three level fusion now or take it slowly, do the minimum necessary now to treat the pain, with the understanding I may need further surgery in the future. Hard choices.

I have an odd spinal stenosis going side to side, L3-4. I've had a hemilaminectomy and TLIF of L4-5 several years ago. I've had 2 opinions, first from my original doc who initially said laminectomy but then 2 months later said he wanted to get a prone MRI first. (On my belly) the second opinion said 3 level fusion. My brother in CA insists I get a third opinion from his spine surgeon. (I'm in the Boston area.) After connecting us on a text, the doctor actually called me. That doc wanted to look at all the images over the last 5 years and have a Zoom call with me, and it would cost $400. He'd only make recommendations and knows I wouldn't travel for surgery. I'd also need to register with the hospital, which costs $185. I'm on Medicare and so I pay nothing in MA for doc visits. I'm tempted to go to this doc's colleague here, Dr Eric Woodard at New England Baptist Hospital. Any thoughts or suggestions out there? Anyone have experience with Dr Woodard?

I have a conundrum: MRI in May 2026 radiology report described mild spinal stenosis, L3-4 but the neurosurgeon wanted to do a laminectomy. He read the scan differently. I had a CT scan in July and it said mild spinal stenosis L3-4. Yesterday I had a nasty fall (3rd fall in 6 weeks.) . They did a CT scan in the ED that said moderate to severe stenosis. My doctor had ordered a prone(on my belly) MRI which I had yesterday before I fell. Those results aren't in yet. I see the doctor in a few days. What am I looking at? Why such a discrepancy? The doctor had said the stenosis was side to side, when usually it's front to back and that may be why they missed it on the first MRI.
I'm sore this morning.

Second opinion???

Three. 2 wanted to do 3-4 levels of fusion. Just in case, levels above and below the fused L4-5. I'm going with the least invasive which is the surgeon who did my last two surgeries.

My issue was L3-L-5. I had a lumbar laminectomy 30 years ago. At the time, second opinions were mandated by my insurance company before surgery was approved. I had the surgery and have had very few issues since then. These days, testing is more precise but it still requires interpretation and diagnosis. Be confident in your doctor even if you need 3 opinions to get there. Doctors are not infallible and should have enough confidence to encourage second opinions.